摘要
目的评价化疗对肺癌疼痛的镇痛作用并探讨肺癌疼痛的治疗策略。方法63例肺癌中度疼痛40例,重度疼痛23例。16例小细胞肺癌以CEP(CTX,Vp16,DDP)或VMFCP(Vp16,MTX,5Fu,CTX,DDP)方案化疗,47例非小细胞肺癌以NP(NVB,DDP)或CAP(CTX,ADM,DDP)方案化疗,并评价镇痛作用。结果疼痛完全缓解(CR)34例(54.0%),部分缓解(PR)27例(42.9%),无效2例,总疼痛缓解率96.8%。16例小细胞未分化癌疼痛缓解率100%,CR11例(68.8%),PR5例(31.2%);22例差分化癌疼痛缓解率100%,CR12例(54.5%),PR10例(45.5%);17例高分化鳞、腺癌疼痛缓解率94.1%,CR6例(35.3%),PR10例(58.8%),无效1例,不同分化程度肺癌疼痛CR率差异有显著性(χ2=4.0166,P<0.05)。胸部、内脏和淋巴结及骨转移疼痛CR率分别为84.2%(16/19),50.0%(5/10)和38.2%(13/34),差异有显著性(χ2=10.39,P<0.001)。肿瘤CR7例均获疼痛CR(100%),肿瘤PR30例疼痛CR18例(58.1%),肿瘤稳定25例疼痛CR9例(36.0%),不同肿瘤疗效组疼痛CR率差异有显著性(χ2=10.04,P<0.001)。中度与重度疼痛CR率(50.0%对41.2%)差异无显著性(χ2=0.7,P>0.05)。结论化疗对缓解肺癌疼痛疗效显著,可作为肺癌疼痛的重要治疗措施。分化程度、疼痛部位和肿瘤客观疗效显著影响化疗镇痛效果。
Objective To evaluate the analgesic efficacy of the chemotherapy for lung cancer pain and investigate treatment strategy of lung cancer pain.Methods Of 63 lung cancer patients,40 had moderate pain and 23 had severe pain. The 16 patients with undifferentiated small cell lung cancer were treated with CEP(CTX,Vp-16,DDP) or VMF-CP(Vp-16,MTX,5-Fu,CTX,DDP) regimen and the 47 patients with non-small cell lung cancer were treated with NP(NVB,DDP) or CAP(CTX, ADM,DDP)regimen. The analgesic efficacy of the chemotherapy for lung cancer pain was evaluated.Results The 34 (54.0%) of 63 lung cancer patients got complete pain remission(CR),27(31.2%) got partial pain remission (PR),and 2 had no remission of pain.The overall pain remission rate was ~96.8% .The 16 undifferentiated small cell cancer patients got pain CR in 11 (68.8%), PR in 5(~31.2% ),with the remission rate of 100%.The 22 poorly differentiated lung cancer patients got pain CR in 12(~54.0% ) and PR in 10(~45.5% ),with remission rate of 100%.The 17 patients with well-differentiated squamous cell carcinoma and adenocarcinoma got pain CR in 6 (35.3%), PR in 10(58.5%)and no remission of pain in 1,with pain remission rate of 94.1%. The pain CR rates were significantly different between the different differentiation degrees(χ2=4.0166,P<0.05).The pain CR rates were 84.2% (16/19), 50.0%(5/10) and 38.2%(13/34)in tumors of chest,viscera,lymph nodes and bone respectively, and were significantly different at different site(χ2=10.39,P<0.01). All of the 7 small cell lung cancer patients whose tumor were CR got pain CR(100%).The 30 patients whose tumors got PR had pain CR in 18 (58.1%). The 25 patients whose tumors were stable got pain CR in 9(36.0%).The pain CR rates were significantly different(χ2=10.04,P<0.001)between different tumor objective response groups.The CR rates of moderate to severe pain were 50.0% and 41.2% respectively with no significant difference(χ2=~0.7 ,P>0.05).Conclusion Chemotherapy is very effective for relief of lung cancer pain. The differentiation de
出处
《中国肿瘤临床与康复》
2005年第3期283-285,共3页
Chinese Journal of Clinical Oncology and Rehabilitation
