羟基喜树碱(拓僖)联合高聚生治疗恶性难治性胸腔积液

Clinical Study on Hydroxycamptothecin (HCPT) Combinedwith Staphylococcin Aureus Filtrate Preparationin the Treatment of Refractory Malignant Pleural Effusions

目的:观察应用羟基喜树碱联合高聚生治疗恶性、难治性胸腔积液的疗效.方法:对临床治疗中效果较差的中、大量恶性胸腔积液及既往治疗无效的恶性胸腔积液患者66例(治疗组36例,对照组30例)进行治疗,全部患者均经PICC管(外周穿刺中心静脉导管)行胸腔闭式引流,1～3天引流至胸水近乎消失后注入药物.治疗组羟基喜树碱(拓僖)30mg,高聚生2000～3 000U胸腔注射,地塞米松5mg肌肉注射;对照组顺铂60～70mg,地塞米松10mg胸腔注射,胃复安20mg肌注.结果:治疗组CR 44.4%(16/36),有效率为86.1%(31/36).对照组CR 26.7%(8/30),有效率为63.3%(19/30).结论:羟基喜树碱联合高聚生治疗恶性难活性胸腔积液疗效满意,不良反应轻微,尤其对大量血性胸腔积液及既往治疗无效者效果良好,安全、可靠,值得临床广泛应用.

Objective: To evaluate the efficacy of Hydroxy-camptothecin (HCPT) plus Aureus Filtrate Preparation (Highly Agglutinative Staphylococcin, HASL) in combined therapy of patients with malignant relapsed and refractory pleural effusion. Methods: Sixty-six patients were involved, of which 36 patients were in the treatment group and 30 patients in the control group. All of the patients were drawn the liquid out of the chest cavity by putting the PICC and then different drugs were administered. In the treatment group, the HCPT 30mg and HASL 2 000～3 000U were administered to the pleural cavity and Dexamethasone 5 mg intromuscular injected, while the Cisplatin(CDDP) 60～70mg and Dexamethasone 10 mg were given to the pleural cavity and Metoclotramidum 20 mg intromuscular injected in the control group. Results: We got the response rate of 86.1%(31/36) with CR rate 55.6% (20/36) in the treatment group and the response rate of 63.3%(19/30) with CR rate 26.7%(8/30) in the control group. Conclusion: The effect is increased significantly in the patients with relapsed and refractory malignant pleural effusion by using HCPT combined with HASL. With the advantage of easy handling, high response rate and also mild side effect, this method will sure be highly recommend in the future.