超声定位导管引流联合分子靶向药物治疗肺癌相关胸水与心包积液

The effect of catheter drainage by ultrasound and molecular targeted drug on pleural effusion and pericardial effusion related with lung cancer

目的：观察超声定位导管引流联合分子靶向药物治疗晚期老年肺腺癌伴恶性胸水及心包积液的近期疗效。方法：18例晚期肺腺癌伴恶性胸腔及心包腔积液的老年患者,采用中心静脉导管胸腔/心包腔闭式引流,同时口服分子靶向药物表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKIs）。观察24h胸水及心包积液引流量,药物不良反应,随诊4周胸水及心包积液情况。结果：治疗4～10d后,胸腔引流量〈100ml/24h;心包引流量〈20ml/24h。置管顺利,无严重并发症。9例出现皮疹,5例腹泻,4例皮疹＋腹泻。随访2例中途停药,1例全身多发转移死亡,5例部分缓解,10例稳定。结论：超声定位导管引流联合口服分子靶向药物,控制老年晚期肺腺癌伴胸水、心包积液近期效果确定,可改善患者生存质量。

Objective： To investigate the effect of catheter drainage by ultrasound and molecular targeted drug on pleural effusion and pericardial effusion related with lung adenocarcinoma. Methods： 18 old patients of lung adenocarcinoma with pleural effusion and pericardial effusion and treated with oral molecular targeted drug（ EGFR-TKIs）and central venous catheter drainage were included into this study. The effect of drainage on pleural and pericardial effusion,toxic and / or adverse effect of EGFR-TKI drug treatment,the over all condition of patients and effusion were observed. Results： The quantity of pleural effusion was less than 100 ml /24 h and the quantity of pericardial effusion was less than 20 ml /24 h in all patients after 4 ～ 10 days＇ of treatment. Central venous catheter drainage was successful and there were no severe complications. In oral drug treatment,there were skin rash in 9 patients,diarrhea in 5 patients,skin rash and diarrhea in 4 patients. At 4 weeks＇ follow-up,there were 2 patients with drug withdrawal,1 patient dead with multiple metastasis,5 patients with partial remission and 10 patients with stable disease. Conclusion：Catheter drainage by ultrasound and molecular targeted drug could soundly control pleural effusion and pericardial effusion related with lung adenocarcinoma in old patients. This method could improve quality of life.