亚砷酸腔内注射治疗恶性胸腔积液的临床观察

Clinical observation of the treatment of malignant pleural effusion by injecting arsenic trioxide into pleural cavity

目的:评价亚砷酸胸腔注射治疗恶性胸腔积液的临床价值。方法:恶性胸腔积液患者68例,均经细胞学和病理学确诊。随机分为治疗组和对照组,在胸膜腔积液充分引流后,治疗组36例,胸膜腔内注射亚砷酸10-20mg,每天或隔日1次,连续3次。对照组32例,胸膜腔内注射博莱霉素30mg/m2,7天1次,共1-2次。观察疗效、毒副反应、生活质量。结果:治疗组CR 10例(27.78%),PR 16例(44.44%),总有效率为72.22%(26/36);对照组CR 8例(25.00%),PR 15例(46.88%),总有效率为71.88%(23/32),两组有效率差异无显著性(P>0.05)。治疗组注药后胸痛反应明显低于对照组(P<0.05),胃肠道反应、骨髓抑制、发热反应两组间无明显差异(P>0.05)。治疗后两组KPS评分均有增加,治疗前后比较有明显差异(P<0.05)。结论:亚砷酸胸腔注射治疗恶性胸腔积液是一种有效、安全的方法。

Objective：To evaluate the clinical value of arsenic trioxide in treating malignant Pleural effusion by in-jecting into Pleural cavity. Methods：Sixty - eight Patients,required to have a cytologically Positive Pleural effusion or a Positive Pleural bioPsy in the Presence of an exudative effusion. After the accumulation of Pleural fluid had been ad-equately drained,36 Patients were randomized to Arsenic trioxide grouP,receiving arsenic trioxide 10 - 20mg,once a day or once two days,on 3 successive times,which were administered via chest tube or directly injected into Pleural cavity. Then the efficacy,toxicity and Perform ancestatus were evaluated. Results：In the Arsenic trioxide grouP,10 Pa-tients（27. 78% ）achieved CR and 16 Patients（44. 44% ）PR,the overall resPonse rate was 72. 22%（26 / 36）. The control grouP 8 Patients（25. 00% ）achieved CR and 15 Patients（ 46 . 88 % ）PR,and the overall resPonse rate was 71. 88%（23 / 32）. The two grouPs had no significant difference in efficiency（P ﹥ 0. 05）. The incidence rate of chest Pain after injection in arsenic trioxide grouP was significantly lower than the control grouP（P ﹤ 0. 05）,gastroin-testinal tract,bone marrow suPPression,fever was no significant difference between the two grouPs（P ﹥ 0. 05）. After treatment KPS scores were increased,there are significant differences before and after treatment（P ﹤ 0. 05）. Conclu-sion：The treatment of malignant Pleural effusion with arsenic trioxide is effective,safe with little side effects.