氟尿嘧啶联合丝裂霉素胸腔注射治疗高龄恶性胸腔积液

Treatment of malignant pleural effusion using 5-Fu and MMC injection into pleural cavity in the elderly

目的 探讨氟尿嘧啶 (5 Fu)联合丝裂霉素 (MMC)胸腔注射治疗高龄恶性胸腔积液的疗效。方法 病理确诊的肺癌伴恶性胸腔积液高龄患者 37例 ,随机分为治疗组 (2 0例 )和对照组 (17例 )。治疗组胸腔内注射 5 Fu 75 0mg m2 ,MMC 8mg m2 ;对照组胸腔内注射顺铂 (DDP) 4 0mg m2 ,每 3～5天一次 ,共 3～ 5次。观察疗效、毒副反应及生活质量。结果 治疗组总有效率为 75 .0 % ,对照组为70 .6 % ,差异无显著性 (P >0 .0 5 )。治疗组骨髓抑制、胃肠反应明显低于对照组 (P <0 .0 5 )。治疗组Karnofsky评分 >6 0分者较对照组显著提高 (P <0 .0 5 ) ,<5 0分者较对照组明显下降 (P <0 .0 5 )。结论 5 Fu联合MMC胸腔注射治疗老年恶性胸腔积液是一种安全性高、毒副反应小、耐受性好的有效方法。

Objective To evaluate the efficacy of 5-fluorouracil (5-Fu) and mitomycin (MMV) injection into pleural cavity in treating malignant pleural effusion.Methods Thirty-seven old patients with malignant pleural effusion were divided randomly into 2 groups.5-Fu 750 mg/m2 and MMC 8 mg/m2 were injected into pleural cavity in therapy group(T),and only cisplatin (DDP) 40 mg/m2 was given in control group (C).The injection was given once 3 to 5 days for 3 to 5 times successively.Then the efficacy,toxicity and quality of life were evaluated.Results The response rate was 75.0% in T group and 70.6% in C group.There was no statistical difference betwee two groups (P>0.05),The Karnofsky score was higher in T group than in C group(P<0.05).Myelosuppession,nausea and vomiting were significantly lower in T group than in C group (P<0.05).Conclusion The treatment with 5-Fu and MMC is a safe,and well tolerable method with little side effects for treating malignant pleural effusion in the elderly.