静脉加中心静脉导管胸腔内双途径联合化疗肺癌并发胸腔积液

Evaluation on Combined Venous and Pleural Chemotherapy with Inserting Central Venous Catheter in Malignant Pleural Effusion from Lang Cancer

目的观察并评价静脉加中心静脉导管胸腔内双途径联合化疗期非小细胞肺癌(NSCLC)并发胸腔积液患者的疗效及毒副反应。方法104例NSCLC并发胸腔积液患者采用中心静脉导管行胸腔闭式引流,胸腔积液引流近乎干净后注入DDP50mg/m2或ADP40mg/m2、BLM30mg/m2、MMC8mg/m2,1次/周,术后5d予NP或MVP、GP、TP、CP、INP等方案静脉化疗,3～4周重复。结果所有病例中CR36例,PR48例,NC20例,有效率80.8%,其中腺癌及鳞癌患者的有效率分别为80.0%、82.4%,两者差异无显著性意义(P>0.05)。初治患者疗效优于复治患者,二者差异有显著性意义(u=2.11,P<0.05)。毒副反应主要为:恶心呕吐(64.4%)、白血胞下降(63.5%)、血红蛋白下降(41.3%)、血小板下降(31.7%)、脱发(51.0%)及胸痛(19.2%)。结论这种方法治疗肺癌并发胸腔积液疗效满意,安全、方便,改善患者生活质量,值得临床推广。

Objective To evaluate the therapxeutic efficacy and adverse reaction of intraperitoneal and pleural chemotherapy with inserting central venous catheter in malignant pleural effusion from advanced non - small cell lung cancer （ NSCLC）. Methods One hundred and four patients were drew the liquid out of the chest cavity by putting the central venous catheter and injected Cisplatin （DDP） 50mg/m^2 or ADM 40mg/m^2, BLM 30mg/m^2, MMC 80mg/m^2 into it once a week. MVP or NP, GP, TP, CP regimen was used after 5 days and repeated after 3 ～ 4 weeks. Results Among 104 patients, the response rate of 80.8%, CR 36 cases, PR48 cases, NC 20 cases. The response rate with cases of adenocarcinoma （80. 0% ） was inconspicuousness difference than that of squamous carcinoma （82. 4% ） （ P 〉 0. 05 ） ; There was significant difference between the response rate of the first treatment and the return treatment （ u =2. 11, P 〈0. 05 ）. The major adverse reaction were nausea and Vomiting （64.4%）, neutropenia （ 63.5% ） , decrease in hemoglobin （ 41.3% ）, thrombocytopenia （ 31.7% ）, alopecia （51.0%）, chest pain （19.2%）, et al. Conclusion This method is convenient, effective, safe for the treament of malignant pleural effusion from NSCLC, it can improve the quality of life. It will sure be highly recommended in the future.