老年恶性胸腔积液患者灌注化疗联合热疗的临床观察

Clinical observation of elderly patients with malignant pleural effusion treated by perfusion chemotherapy combined with hyperthermia

目的探讨老年恶性胸腔积液患者灌注化疗的安全性和疗效分析。方法收集2004年3月至2007年10月的老年恶性胸腔积液患者共49例,分为顺铂(DDP)加IL-2配合热疗组(对照组)和DDP加香菇多糖配合热疗组(实验组),并对生存质量和不良反应进行分析。结果生存质量改善率对照组和实验组分别为62.50%和84.00%。不良反应实验组低于对照组:两组均有发热,对照组为69.00%(15/24),实验组为12.00%(3/25);胸痛发生率对照组和实验组分别为41.70%、24.00%。发生骨髓抑制对照组为50.50%,实验组为16.90%。对照组有效率为83.33%;实验组组有效率为88.00%,两组差异无统计学意义(P>0.05)。结论两组有效率相近,实验组的方案对于老年恶性胸腔积液的患者是更好的选择。

Objective To evaluate the safety and efficacy of the perfusion chemotherapy combined with hyperthermia in elderly patients with malignant pleural effusion. Methods Forty-nine elderly patients with malignant pleural effusion from March 2004 to October 2007 were divided into two groups：DDP＋IL-2 with hyperthermia and DDP＋Lentinan with hyperthermia. Results On quality of life and adverse events analysis, there was significant difference between the two groups. The quality of life improvement rate was 62.50% in the control group and 84.00% in the study group. The adverse events rate of the control group was lower than that of study group. The fever rates in two groups were 69.00% （15/22） and 12.00% （3/25） ,respectively. The incidence of chest pain of the two groups were 41.70% and 24.00% respectively. And myelosuppression was 50.50% and 16.90%. The efficiency of the two groups was similar. DDP ＋ IL-2 combined hyperthermia group was 83.33% ; DDP ＋ lentinan combined hyperthermia group was 88.00%. There was no statistically significant difference between the two groups. Conclusion DDP＋Lentinan combined hyperthermia for elderly patients with malignant pleural effusion is a better choice.