甘露聚糖肽联合卡铂胸腔内灌注治疗恶性胸腔积液疗效观察

Observation of the Efficacy of Intra-Pleural Injection of Mannatide and Carboplatin in Treatment of Malignant Pleural Effusion

目的观察甘露聚糖肽联合卡铂胸腔内灌注治疗恶性胸腔积液的疗效,安全性和耐受性。方法 29例恶性胸腔积液患者随机分为两组,A组16例和B组13例。A组于胸腔内灌注卡铂,400 mg,每周1次。B组同时灌注卡铂和甘露聚糖肽,卡铂的剂量同A组,甘露聚糖肽的剂量为60 mg,每周1次。结果 A组CR 2例(12.5%),PR 4例(25%),有效率为37.5%。B组CR 5例(38.5%),PR 6例(46.2%),有效率(RR)为84.7%。B组有效率高于A组,差异有统计学意义。全组患者生活质量改善20例,KPS评分改善率达69%。所有患者耐受性好,无治疗相关死亡,主要的毒性反应为胃肠道反应和骨髓抑制。结论甘露聚糖肽联合卡铂胸腔内灌注治疗恶性胸腔积液疗效肯定,临床安全性好,不良反应发生低,能改善生活质量,值得临床推广。

Objective To study the efficacy, safety and tolerability of mannatide and carboplatin in treatment of malignant pleural effusion. Methods 29 cases of patients with malignant pleural effusion were randomly divided into two groups, A group and B group. A group was treated by intra-pleural injection of carboplatin,400 mg,once a week. B group was treated by intra-pleural injection of carbopla- tin and mannatide, the dose of carboplatin was the same as A group, the dose of mannatide was 60mg, once a week. The efficacy and toxicity were evaluated in all patients after 3 weeks. Resul~ In A group ,2 cases were CR （ 12. 5% ） ,4 cases were PR （25%） ,the response rate （ RR = CR ＋ PR） was 37.5%. In B group,5 cases were CR （38.5%） ,6 cases were PR （46. 2%） ,the response rate （ RR = CR ＋ PR） was 84. 7 %. The response rate of B group was higher than A group, the difference was statistically significant. Well tolerated in all patients, no treatment-related death occurred,the main toxicities were gastrointestinal reactions and bone marrow suppression. Conclusion Intrapleural injection of mannatide and carboplatin to treat of malignant pleural effusion has a certain efficacy, a good safety and fewer adverse reactions.