重组人血管内皮抑制素与顺铂治疗恶性胸腹水的疗效比较

Effect of Recombinant HumanEndostatin Treatment for Malignant Pleural Effusion or Malignant Ascites compared with Cisplatin

目的观察重组人血管内皮抑制素治疗胸腹腔积液的近期疗效及安全性评估。方法 56例恶性胸腹腔积液患者随机分成两组,重组人血管内皮抑制素(恩度)治疗组为观察组26例,顺铂治疗组为对照组30例,所有患者经B超定位后行胸(腹)腔穿刺置单腔中心静脉导管,置管后尽可能引流尽胸腹水,观察组每周2次胸(腹)腔内注射重组人血管内皮抑制素,30mg/次,对照组胸(腹)腔内推注顺铂40mg,2次/周,每3周为1个周期。评价近期疗效、不良反应及生活质量变化。结果两组患者均可进行客观疗效评价及安全性评估,观察组RR为50%,对照组RR为56.67%,两组疗效无显著差异。全组患者生活质量改善者为32例,稳定者12例,占比78.57%。全部56例患者,出现3～4级毒性反应的仅有9例,均为对照组,包括白细胞减少3例,恶心呕吐6例。白细胞减少、消化道反应(恶心、呕吐)、乏力等不良反应的发生率,观察组明显优于对照组,具有统计学意义。结论重组人血管内皮抑制素用于恶性胸(腹)水的治疗,有良好的近期疗效,不良反应轻微,生活质量得以改善。

Objective To observe the short-term curative effect and the safety assessment of Malignant pleural effusion or malignant ascites with recombinant human endostatin injection.Methods 56 Malignant pleural effusion or malignant ascites patients were divided into 2 groups randomly;the observation group had 26 cases and the control group 30 cases.All the patients were placed with a single lumen central venous catheter（CVC） by pleural/abdominal puncture under the guide of ultrasound.We tried to drain the effusion as much as possible.The observation group control received endostar 2 times 30mg/person weekly by intrapleural/intraperitoneal injection,and the control group 2 times 40mg/person weekly.Every 3 weeks is a treatment cycle.We evaluate the short-term curative effect,negative effects and life quality of the 2 groups.Results Clinical curative effect and safety assessment of the 2 groups could be appraised.The RR of the observation group is 50%,and the control group 56.67%,which means their curative effect,has no statistical difference.Of all the patients,32 patients＇ life qualities were improved,12 had stable life quality.That accounted for 78.57%.The cisplation injection is found to make 9 cases sick with toxicity reactions,including 3 cases of WBC reduction and 6 cases of nausea and vomiting.The incidence rate of WBC reduction,digestive tract reaction and weakness of the observation group is much less than the control group,which has statistical signification.Conclusion Endostar treatment of malignant pleural effusion or malignant ascites has a good short-term curative effect,with less adverse effect and it can improve life quality apparently,all of these make it deserve to be further researched.