伯尔定腔内给药治疗恶性浆膜腔积液的临床观察

Clinical observation of paraplatin used within the cavity for malignant serous cavity effusion

目的评价卡铂(伯尔定)腔内给药治疗恶性浆膜腔积液的疗效及其毒副作用。方法对于恶性浆膜腔积液患者,采用中心静脉导管穿刺并置管,适量抽弃腔内积液后,腔内注入伯尔定150～450m g,每周给药1～2次,直至积液消失或判定无效后换药。结果本组76例可以评价疗效和毒副反应,治疗后完全缓解(C R)21例(28%),部分缓解(PR)33例(43%),无效(N R)22例(29%),总有效率71%。其中胸腔积液34例,有效率为79%(27/34);腹腔积液26例,有效率为50%(13/26);心包积液16例,有效率为87%(14/16)。全组毒性反应轻微,主要为Ⅰ～Ⅱ度骨髓抑制。结论伯尔定腔内治疗恶性浆膜腔积液疗效确切,毒副作用小,是一优选药物。

Objective To evaluate the efficacy and toxicity of paraplatin used within the cavity for the treatment of malignant serous cavity effusion. Methods Puncturing with catheter of centre vein and permanent catheter, withdrawing proper volume of malignant effusion, 150 ～ 450 mg paraplatin was infused into the serous cavity each time for once or twice a week till the effusion was disappeared or there was no change. Results 76 cases were evaluable for response and toxicity. There were 21 patients with CR, 33 patients with PR and 22 patients with NR. The ORR was 71 %. Among them, the RR in malignant pleural effusion group was 79 %(27/34), 50 %(13/26) in the peritoneal effusion and 87 %(14/16) in the pericardial effusion. Only I ~ II degree bone marrow suppression was observed. Conclusions Paraplatin used within the cavity is more effective and safe for treating malignant serous cavity effusion.