摘要
目的观察腔内注射亚砷酸治疗恶性胸水的疗效和毒副作用。方法2003年1月至2004年10月,将入组的32例患者随机分成3组:亚砷酸单药组,亚砷酸联合化疗药DDP组和化疗药DDP组。行中心静脉导管留置胸腔引流,尽量将胸水排净后,腔内依不同分组注入药物,4周评价疗效。结果32例患者均可评价疗效和副作用。亚砷酸联合DDP组有效率为91.6%,显著高于亚砷酸组的有效率44.4%(P=0.046),也显著高于单药DDP组的有效率45.5%(P=0.027);而亚砷酸组和DDP组的有效率差异无显著性(P=1.000)。亚砷酸组患者的生活质量改善率为77.8%,高于单药DDP组的生活质量改善率18.2%,差异有显著性(P=0.022);亚砷酸联合DDP组的生活质量改善率为41.7%,和单药DDP组相比差异有显著性(P=0.371);而亚砷酸组和亚砷酸联合DDP组的生活质量改善率差异无显著性(P=0.184)。亚砷酸治疗组出现的主要副作用为Ⅰ～Ⅱ度的头痛(4/9)、胸痛(5/9)和心悸(3/9),DDP组和亚砷酸联合DDP组均出现DDP相关副作用。结论腔内注射亚砷酸治疗恶性胸水疗效确切,副作用轻微,易于耐受。对于一般状态较好,能够耐受化疗的恶性胸腔积液患者,可以腔内给予亚砷酸联合化疗药物治疗;对于一般状态较差,不能耐受化疗的恶性胸腔积液患者,则可以考虑腔内注入单药亚砷酸治疗。
Objective To evaluate the efficacy and side-effect of arsenic trioxide in treatment of malignant hydrothorax. Methods Thirty-two consecutive patients with malignant hydrothorax entered the trial from January 2002 to October 2005. The patients were randomly divided into 3 groups,intracavitary receiving As2O3, As2O3 ＋ DDP and DDP respectively. Results Thirty-two patients were evaluable for response and toxicity. As2O3 ＋ DDP group had significantly higher objective response rate （91.6%） than As2O3 group （44.4%） and DDP group （ 45.5% ） （ P = 0. 046 and 0. 027 respectively ）. As2O3 group has higher clinical benefit response of KPS （ 77.8 % ） than DDP group （ 18.2 % , P = 0.022 ） and As2O3 ＋ DDP group （41.7%, P = 0.371 ）. The major toxic effects of As2O3 group were moderate headache, chest pain and palpitation. All toxic reactions of As2O3 ＋ DDP group and DDP group were related to DDP. Conclusion Arsenic trioxide has good effective rate and low toxicity in treatment of malignant hydrothorax and can also improve the patients＇ quality of life.
出处
《中国肿瘤临床与康复》
2008年第1期55-57,共3页
Chinese Journal of Clinical Oncology and Rehabilitation
基金
黑龙江省科技攻关项目(GC03C606-2)
关键词
亚砷酸
恶性胸水
疗效
Arsenic trioxide
Malignant hydrothorax
Efficacy
