重组人血管内皮抑制素治疗恶性胸腹腔积液的临床观察

Clinical observation of endostar in the treatment of malignant serous cavity effusion

目的:观察重组人血管内皮抑制素(恩度)治疗恶性胸腹腔积液的近期疗效,评价恩度局部应用的安全性和耐受性。方法:对25例伴有恶性胸腹腔积液的晚期恶性肿瘤患者,应用恩度胸腹腔灌注给药(单药组),尽可能抽出胸腹腔内积液,注入恩度30mg,每周2～3次,治疗2～3周,待胸腹水量稳定后可以每周1次维持治疗。其中10例患者同时接受恩度联合顺铂胸腹腔局部灌注治疗(联合组)。每21天为1个周期。评价近期疗效、生活质量以及毒副反应。结果:25例患者均可进行客观疗效评价及安全性评价,CR2例,PR11例,SD6例,PD6例,客观有效率(RR)为52%,疾病控制率(DCR)为76%。联合组客观有效率高于单药组,但无统计学差异。全组患者生活质量改善者有20例,占80%。药物相关性毒副反应不明显。结论:恩度胸腹腔灌注给药能较好地控制恶性胸腹水,减轻临床症状。恩度与化疗药物联合局部治疗可能具有一定的协同作用,可以改善患者生活质量,安全性较好,不增加化疗药物的不良反应。

Objective：To observe the clinical efficacy of recombinant human endostatin （endostar） in the treatment of malignant thoracic effusion, and evaluate the safety and tolerability of local application of the endostar injection. Methods ： Endostar thoracic cavity perfusion（ monotherapy group）was applied in 25 cases of patients with advanced cancer. Following a maximum release of thoracic cavity fluid, endostar 30mg or along with 20ml saline could be injected in,2 or 3 times a week for 2 to 3 weeks. Then once a week for a maintainence of treatment. Among them, 10 patients at the same time received endostar thoracic cavity local chemotherapy with cisplatin（joint group）, 21 days makes a cycle. To evaluate its recent efficacy, quality of life, as well as toxicity. Results：Twenty-five cases of patients could be given an objective evaluation of the efficacy and safety, 2 cases of CR, 11 cases of PR, 6 cases of SD, 6 cases of PD with a 52% objective efficiency rate（ RR）, 76 % disease control rate（DCR） ; objective efficiency rate in the joint group was higher than the single-drug group in terms of the absolute value,but with no significant difference; In the whole group 20 cases of patients were found to improve their quality of life, accounting for 80% ; drug-related toxicity was not obvious. Conclusion：Endostar thoracic cavity infusion can better control the malignant ascites to reduce the clinical symptoms. Endostar in combination with the chemotherapy drug may play a joint role to improve the patients＇s quality of life. Clinical safety is better, with no accumulated adverse reactions.