MMC与DDP交替腔内化疗治疗肺癌并心包积液

Alternative Intra-pericardial Chemotherapy of MMC and DDP in the Treatment of Patients with Lung Cancer and Pericardial Effusion

目的：观察总结丝裂霉素（MMC）与顺铂（DDP）交替化疗治疗肺癌并心包积液的疗效及毒性反应。方法：37例肺癌并心包积液患者均在B超或彩超引导下心包腔置入中心静脉导管引流,每日少量引流并MMC与DDP交替腔内化疗（其中MMC 2mg/d、DDP 20~30 mg/d至MMC总量8~10 mg、DDP 90~100 mg）。结果：CR 25例,PR 10例,NR 2例,总有效率94.6%。治疗后发热4例,其中高热1例;胃肠道反应12例,主要为Ⅰ~Ⅱ度;骨髓抑制14例,主要为Ⅰ度。结论：心包腔闭式引流加MMC与DDP小剂量交替化疗是控制肺癌并心包积液的有效方法。

Objective： To observe and summarize the efficacy and side effect ofintra-pericardial chemotherapy of MMC and DDP on malignant pericardial effusion of lung cancer. Methods： Thirty-seven cases of lung cancer with malignant pericardial effusion were all drained with using central venous catheter guided by B-mode or color Doppler ultrasound. A small amount of drainage was conducted on daily basis with alternative intra-pericardial chemotherapy of MMC and DDP （there into, MMC 2 mg/d, DDP 20-30 mg/d to the total of MMC to 8-10 mg, DDP 90-100 mg）. Result： The total effective rate was 94.6% with 25 cases of CR and 10 cases of PR. After treatment, 4 patients developed fever （1 case of high fever）, 19 eases developed gastrointestinal tract reaction （mainly grade Ⅰ - Ⅱ）, 14 developed myelosuppression （mainly grade Ⅰ ）. Conclusion： Central venous catheter drainage with alternative injection of MMC and DDP in small doses into pericardial cavity may be a better way to control malignant pericardial effusion of lung cancer.