贝伐单抗和顺铂联合治疗非小细胞肺癌恶性胸腔积液的疗效评价

Evaluation of curative effect of bevacizumab combined with cisplatin in treatment of non-small cell lung cancer with malignant pleural effusion

目的探讨贝伐单抗和顺铂联合治疗非小细胞肺癌恶性胸腔积液的临床效果。方法选取2011年5月至2015年4月于我院诊治的并发恶性胸腔积液非小细胞肺癌患者共73例进行研究。按照随机原则分为研究组（n=37）和对照组（n=36），对照组实施顺铂常规化疗，研究组采用顺铂联合贝伐单抗治疗。比较2组患者治疗前后不同时间胸腔积液中血管内皮生长因子（VEGF）水平、生活质量评分、药物不良反应，并评定临床疗效。结果2组患者在治疗后1周、2周、3周的VEOF水平均明显低于治疗前（P值均〈0．05），且研究组较对照组降低更明显（P值均〈0．05）；研究组和对照组的近期总有效率分别为81．08％和58．33％，生活质量评分总稳定率分别为75．68％和52．78％，研究组均高于对照组（x^2值分别为4．484、4．172，P值均〈0．05）；2组患者不良反应发生率差异均无统计学意义（P值均〉O．05）。结论对并发恶性胸腔积液非小细胞肺癌患者行贝伐单抗和顺铂联合治疗，患者胸水中VEGF水平控制好，生活质量明显改善，药物不良反应发生率低，效果显著，值得推广。

Objective To evaluate the clinical effect of bevacizumab combined with cisplatin in treatment of non-small cell lung cancer with malignant pleural effusion. Methods 73 cases of non-small cell lung cancer with malignant pleural effusion in our hospital from May 2011 to April 2015 were chosen. And all patients were randomly divided into the study group （ n =37） and the control group （ n =36）. The patients in control group were treated with cisplatin, while the patients in study group were treated with cisplatin and bevacizumab. The level of vascular endothelial growth factor （VEGF） before and after treatment, quality of life score, drug toxicity, and clinical efficacy between two groups were compared. Results After treatment for one week, two weeks, three weeks, VEGF level in two groups was significantly lower than that before treatment （ P 〈 0.05）, and VEGF level in the study group was significantly lower than that in the control group （ P 〈0.05）. The total effective rate of the study group and the control group was 81.08% and 58.33%, and the total stable score of the study group and the control group were 75.68% and 52.78%, the above indexes in the study group were higher than those in the control group （ x^22 ： 4. 484,4. 172, all P 〈0.05）. There was no significant difference in the incidence of toxic reactions between the two groups （ P 〉0.05）. Conclusions Bevacizumab and cisplatin are used in treating the patients with malignant pleural effusion caused by non-small cell lung cancer, VEGF level in pleural effusion is well controlled, and life quality of the patients is significantly improved, drug toxicity is low, the effect is significant, worthy of promotion.