摘要
目的回顾性分析69例肺癌合并恶性胸腔积液(malignant pleural effusion,MPE)患者的临床资料,探讨恩度与顺铂胸腔内灌注治疗肺癌合并MPE的短期疗效和不良反应。方法收集陆军军医大学新桥医院2016年至2018年6月收治的69例肺癌合并MPE患者的临床资料,根据治疗方法的不同,分为恩度组23例,顺铂组46例。两组治疗前均已排尽胸水,恩度组胸腔灌注恩度30 mg,每周2次,顺铂组胸腔灌注顺铂30 mg/m^2,每周2次,比较两种药物的疗效及不良反应的差异。结果恩度组的客观有效率(objective response rate,ORR)为56.5%,顺铂组ORR为26.1%。恩度组的治疗效果显著优于顺铂组,差异有统计学意义(P<0.05)。分层分析发现,在血性胸腔积液患者中,恩度组ORR 88.9%,顺铂组ORR 5%,差异有统计学意义(P<0.05)。在非血性胸腔积液患者中,恩度组ORR 35.7%,顺铂组ORR 42.3%。胸腔积液中癌胚抗原(carcinoembryonic antigen,CEA)数值较低(<100μg/L)的患者中,恩度组ORR 53.8%,顺铂组ORR 8.3%,差异有统计学意义(P<0.05)。胸腔积液中CEA数值较高(≥100μg/L)的患者中,恩度组ORR 50%,顺铂组ORR 45.4%。结论恩度胸腔内灌注治疗原发性肺癌合并MPE是一种安全有效的治疗方法,疗效优于顺铂,尤其对于血性胸腔积液患者、胸腔积液中CEA数值较低(<100μg/L)的患者,效果更为明显。且恩度组较顺铂组不良反应更小,安全性好,能明显改善患者生活质量。
Objective To analyze the clinical data of 69 patients with primary lung cancer mediated malignant pleural effusion( MPE) and explore the therapeutic effects and adverse reactions of endostar and cisplatin in the treatment of lung cancer mediated MPE through intrapleural injection. Methods The clinical data of 69 patients with lung cancer mediated MPE in our hospital from 2016 to June 2018 were collected for this study. They were divided into two groups according to the therapeutic regimen: 23 cases were treated with endostar( 30 mg through intrapleural injection,twice a week) and the rest 46 cases were treated with cisplatin( 30 mg/m2 through intrapleural injection,twice a week). The curative effects and adverse reactions of the two groups were observed and analyzed. Results The objective response rate( ORR) was 56.5% in the endostar group,which was significantly higher than that in the cisplatin group( 26. 1%,P < 0. 05). Stratified analysis showed that in the patients with bloody pleural effusion,the ORRs were 88.9% in the endostar group and 5% in the cisplatin group,and the difference was statistically significant between the two groups( P < 0. 05). In the patients with non-bloody pleural effusion,the ORRs were 35. 7% in the endostar group and 42. 3% in the cisplatin group. In the patients with lower carcinoembryonic antigen( CEA) values(<100 μg/L) in the pleural effusion,the ORRs were 53. 8% in the endostar group and 8. 3% in the cisplatin group,and statistical significant difference was found between the two groups( P < 0. 05). In the patients with higher CEA values(>100 μg/L) in the pleural effusion,the ORRs were 50% in the endostar group and 45.4% in the cisplatin group. Conclusion Intrapleural therapy of endostar is a safe and effective method for the patients with lung cancer mediated MPE,which shows a higher curative rate than that of cisplatin. The therapeutic effect is more obvious especially for the patients with bloody pleural effusion and the patients with lower CEA values(< 100μg/L) in the pleur
作者
王洲飞
许子寒
朱广阔
卓文磊
陈正堂
Wang Zhoufei;Xu Zihan;Zhu Guangkuo;Zhuo Wenlei;Chen Zhengtang(Cancer Research Institute of PLA,Xinqiao Hospital,Army Military Medical University,Chongqing 400037,China)
出处
《中华肺部疾病杂志（电子版）》
CAS
2019年第5期539-543,共5页
Chinese Journal of Lung Diseases(Electronic Edition)
基金
国家自然科学基金资助项目(81672841)
关键词
支气管肺癌
恶性胸腔积液
恩度
顺铂
腔内注射
Bronchogenic carcinoma
Malignant pleural effusion
Endostar
Cisplatin
Intrapleural injection
