CCE化疗联合胸腔内灌注平阳霉素、消瘤芥治疗肺癌伴胸腔积液51例临床观察

The clinical investigation on intrathoracic instillation of CCE chemotherapy combined PMY and AT-1258 in 51 patients with lung cancer accompaning hydrothorax

目的 观察CCE化疗联合胸腔内灌注平阳霉素、消瘤芥治疗肺癌伴胸腔积液疗效。方法 静脉化疗方案为CTX5 0 0～ 60 0mg/m2 及CBP3 0 0mg/m2 ,第一天 ;VP1610 0mg/日 ,第 1～ 5天 ,2 8天为一疗程 ;胸腔内灌注药物治疗 ,抽水后胸腔灌注平阳霉素 16mg ,消瘤芥 40～ 60mg ,地塞米松 10mg ,7～ 10天一次。 结果 肺癌总有效率 5 4.9% ;胸腔积液的有效率为 80 .4% ,其中少量胸水有效率 10 0 % (12 /12 ) ,中量胸水有效率 82 .1% (2 3 /2 8) ,大量胸水 5 4.5 % (6/11) ,三者间有差异 (P <0 .0 2 5 ) ;毒副反应主要是骨髓抑制、消化道反应和脱发。生存 3～ 3 0个月 ,中位生存 12个月。结论 本文认为肺癌伴胸腔积液者在CCE化疗同时行胸腔内灌注平阳霉素、消瘤芥 ,此方法简单易行 ,可推广应用。

Objective To evaluate the effect of CCE chemotherapy combined PYM and AT 1258 intrathoracic instillation on lung cancer accompanied hydrothorax.Methods The chemotherapy remedy was CTX 500～600mg/m 2 iv d1,CBP 400mg iv d1 and Vp 16 100mg iv d1～5.The therapeutic course was repeated at 4 weekly intervals.After drawing water,PYM 16mg and AT 1258 40～60mg and dexamethsome 10mg were injected into thoracic cavity,which was repeated at 7～10 days intervals.Results The effective rate in patients with lung cancer and hydrothorax was 54.9% and 80.4%,respectively.The effective rate for mild、moderate and severe hydrothorax were 100%(12/12),82.1%(23/28)and 54.5%(6/11)(P<0.025).The side effects were arrest of bone marrow,digestive tract reaction and alopecia.The survival time was 3～30 months,the median survival time was 12 months.Conclusions CCE chemotherapy combined PYM and AT 1258 intrathoracic instillation in the treatment of lung cancer accompanied with hydrothorax is simple,effective,therefore it should be recommended. [