吉非替尼联合胸腔内化疗治疗伴恶性胸水的非小细胞肺癌的初步疗效观察

Primary result of the efficacy and safety of gefitinib combined with intrathoracic chemotherapy in advanced non-small cell lung cancer patients with pleural effusion

目的:探讨吉非替尼联合胸腔内化疗治疗伴恶性胸水的非小细胞肺癌的疗效和安全性。方法:22例伴中、大量恶性胸水的晚期非小细胞肺癌患者,采用胸腔置管引流尽量放干胸水后,胸腔内注射化疗药物顺铂(DDP)40mg/m2、香菇多糖2mg、地塞米松10mg,从胸腔内化疗后的第3天口服吉非替尼250mg/d,直到病变进展或其他原因停药。每3个月对病灶进行1次CT检查。结果:第3个月CT复查结果显示:全组胸水控制有效率为72.7%(18/22),肿瘤病灶治疗有效率为36.4%(8/22),疾病控制率86.4%(19/22),临床受益反应为90.9%(20/22)。中位随访8.5(2-22)个月,目前仍存活18例,其中10例仍处于疾病控制中,8例生存期已超过1年。主要毒性反应是Ⅰ、Ⅱ度皮肤毒性。结论:吉非替尼联合胸腔内化疗治疗伴恶性胸水的非小细胞肺癌具有较好的疗效和安全性。

Objective：To evaluate the efficacy and safety of gefitinib combined with intrathoracic chemotherapy in advanced non - small cell lung cancer patients with pleural effusion. Methods： For 22 advanced NSCLC patients with medium or abundant pleural effusion, the pleural effusion was emptied with thoracentesis, Ther intrathoracic chemotherapy was given：cisplatin （DDP） 40mg/m2, lentinan 2mg, dexamethasonen 10rag. All patients receivedgefitinib of 250mg/d after 3 days from intrathoracic chemotherapy until disease progression or other reasons. The tumor was examined by CT every 3 months. Results ： All patients were examined by CT after 3 months, the response rate of pleural effusion was 72.7% （18/22）, tumor response rate was 36.4% （8/22）, disease control rate was 86. 4% （ 19/22）, clinical benefit response 90.9% （20/22）. The median follow - up time was 8.5 months （ range 2 - 22 months）. Of the 18 patients who were still alive when following- up ended, 10 patients had stable disease, 8 pa- tients had survived more than one year. The main side effect was grade I or II skin toxicity. Condtmion： Gefitinib combined with intrathoracic chemotherapy is feasible and effective for advanced non - small cell lung cancer patients with pleural effusion.