rmhTNF治疗晚期肿瘤恶性心包积液疗效的影响因素分析

Analysis of factors affecting curative effect of rmhTNF on malignant pericardial effusion caused by advanced malignant tumors

目的:分析影响重组改构人肿瘤坏死因子(rmhTNF)治疗晚期肿瘤恶性心包积液疗效的影响因素。方法:回顾性分析76例晚期肿瘤恶性心包积液患者采用置管灌注rmhTNF治疗心包积液的临床资料。通过对患者性别、年龄、心包积液量、KPS评分、全身转移情况、治疗用药剂量等因素与治疗心包积液有效率的统计分析,判断这些因素对治疗疗效的影响。结果:本研究76例中54例有效,总有效率71.0%(小剂量组有效率50.0%,大剂量组有效率92.1%)。rmhTNF治疗恶性心包积液的疗效在患者性别、年龄、全身转移情况等方面差异不明显;而在心包积液量、KPS评分、rmhTNF剂量等方面存在比较明显的差异。结论:rmhTNF治疗心包积液疗效较好,尤其是对一般情况较好(KPS>60分)的中少量心包积液患者采用大剂量rmhTNF治疗效果更明显,同时无明显增加的毒副作用。

Objective：To analyze the factors affecting the curative effect of rmhTNF on malignant pericardial effusion caused by advanced malignant tumors. Methods： 76 patients with malignant pericardial effusion caused by advanced malignant tumors were treated with rmhTNF through intrathoracic injection. Then the relationships between the effective rate and the age, sex, the amount of pericardial effusion, KPS score, metastasis and the dose of rmhTNF were analyzed retrospectively. Their influences on the curative effect of rmhTNF were evaluated eventually. Results ：The rmhTNF treatment was effective in 54 of all 76 patients, and the total response rate was 71.0% （50.0% in low dose group ,92.1% in high dose group）. There were not any significant effects of the age, sex, and metastasis of patients on the curative the results, but the amount of pericardial effusion, KPS score of patients and dosage of rmhTNF had significant effects. Conclusion ： The curative effect of rmhTNF on malignant pericardial effusion is good, especially for patients with small to middle amount of pericardial effusion and in good condition （ KP 〉 60） by using high dose rmhTNF,and-the incidence rate of adverse events do not increase significantly.