摘要
背景与目的:心包穿刺抽液后心包腔内药物治疗是治疗恶性心包积液的主要手段。本研究观察足叶乙甙(VP-16)联合顺铂(DDP)心包腔内注射治疗非小细胞肺癌恶性心包积液的疗效及不良反应。方法:对28例非小细胞肺癌恶性心包积液的患者行心包穿刺术,尽可能抽尽液体后心包腔内注入VP-16200～300mg和DDP80～100mg,局部治疗后2周行全身化疗。结果:28例患者首次治疗有效率85.7%,完全缓解率71.4%,2次治疗总有效率100%。仅4例患者需行二次穿刺治疗。治疗后胃肠道反应16例,主要为Ⅰ～Ⅱ度;骨髓抑制12例,主要为Ⅰ度;转氨酶轻度升高1例。24例初治患者中,ⅢB期患者中位生存期14个月,Ⅳ期患者中位生存期10.9个月;复发的4例患者中位生存期6个月(从复发日起计算)。结论:心包穿刺抽液加心包腔内注入VP-16联合DDP是恶性心包积液有效的治疗方法。
BACKGROUND ＆ OBJECTIVE： Pericardiocentesis and intrapericardial infusion of chemotherapeutic drugs is the main treatment of malignant pericardial effusion. This study was to observe the efficacy and side effect of intrapericardial infusion of etoposide （VP-16） and cisplatin （DDP） on malignant pericardial effusion of non-small cell lung cancer （NSCLC）. METHODS. Twenty-eight NSCLC patients with malignant pericardial effusion were treated with pericardiocentesis and intrapericardial infusion of VP-16 （200-300 mg） and DDP （80-100 mg）. Intravenous chemotherapy were given 2 weeks after the pericardiocentesis. RESULTS： The overall response （OR） rate of the first-time treatment of the 28 patients was 85.7%, with complete response （CR） rate of 71.4%; the OR rate of the second-time treatment was 100%. Only 4 patients needed second-time pericardiocentesis. Sixteen patients developed gastrointestinal tract reaction （mainly grade Ⅰ-Ⅱ）, 12 developed myelosuppression （mainly grade Ⅰ）, and 1 showed mild abnormal of transaminase. For the 24 naive patients, the overall survival time was 14 months for stageⅢ B and 10.9 months for stage Ⅳ; whereas for the 4 patients with relapsed disease, the overall survival time was 6 months （from the time of relapse）. CONCLUSION： Intrapericardial infusion of VP-16 and DDP is an effective treatment for malignant pericardial effusion of NSCLC.
出处
《癌症》
SCIE
CAS
CSCD
北大核心
2006年第4期505-508,共4页
Chinese Journal of Cancer
关键词
肺肿瘤
恶性心包积液
化学疗法
足叶乙甙
顺铂
Lung neoplasm
Malignant pericardial effusion
Chemotherapy
Etoposide
Cisplatin
