非小细胞肺癌并恶性心包腔积液双路径化疗临床疗效分析

Clinical Effects of Double-way Chemotherapy on Non-small Cell Lung Cancer with Malignant Pericardial Effusion

目的探讨晚期非小细胞肺癌并恶性心包腔积液双路径化疗的疗效.方法选择42例经细胞学和/或组织学确诊的非小细胞肺癌并恶性心包腔积液的患者,所有患者均行心包腔置管闭式引流,随机分为A组和B组,每组各21例.A组患者应用全身化疗+心包灌注CDDP(顺铂)及IL-2(重组人白细胞介素-2)治疗,B组患者应用全身化疗+心包灌注CDDP治疗.结果 42例晚期非小细胞肺癌并心包膜腔积液患者双路径化疗的RR为73.8%(31/42).其中,A组21例患者的CR为76.2%(16/21),PR为14.3%(3/21),RR为90.5%(19/21);B组21例患者的CR为33.3%(7/21),PR为23.8%(5/21),RR为57.1%(12/21).比较A组和B组患者的总有效率,差异有统计学意义(P<0.05).结论心包膜腔积液系晚期非小细胞肺癌常见并发的急症,在短期内致心脏填塞威胁患者的生命,全身化疗加心包膜腔内灌注CDDP联合IL-2的双路径化疗方法治疗晚期非小细胞肺癌所致恶性心包积液,近期疗效好,值得在临床进一步探讨.

Objective To investigate the effect of double-way chemotherapy on non-small cell lung cancer with malignant pericardial effusion.Method We selected 42 cases of confirmed non-small cell lung cancer with malignant pericardial effusion by cytological and / or histological examination.All 42 patients underwent pericardial cavity closed drainage,and were randomly divided into A group and B group（21 patients in each goroup）.Patients in A group were ginven systemic chemotherapy with pericardial perfusion treatment of CDDP and IL-2,while patients in B group were given systemic chemotherapy with pericardial perfusion treatment of CDDP only.Results The overall response rate of double-way chemotherapy was 73.8%（31/42）.In A group,CR of 21 patients was 76.2%（16/21）,PR was 14.3%（3 / 21）,RR was 90.5%（19/21）;in B group,CR of 21 patients was 33.3%（7 / 21）,PR was 23.8%（5 / 21）,RR was 57.1%（12/21）.The difference in the total efficiency was statistically significant between these two groups（P〈0.05）.Conclusions Pericardial effusion is a common emergent complication of advanced non-small cell lung cancer,and it will lead to cardiac tamponade which could threat the lives of patients in a short time.The double-way chemotherapy of systemic chemotherapy and intravesical instillation of CDDP combined pericardial IL-2 in Non-small cell lung cancer with malignant pericardial effusion has good curative effect,and deserve further exploration in clinical.