重组改构人肿瘤坏死因子胸腔灌注法治疗老年肺癌恶性胸腔积液的疗效观察

Clinical observation of recombinant human tumor necrosis factor alpha by intrapleural perfusion in the treatment of malignant pleural effusion in elderly patients with lung cancer

目的研究分析重组改构人肿瘤坏死因子胸腔灌注应用于老年肺癌恶性胸腔积液的治疗效果。方法选择64例晚期肺癌老年患者,按照随机数字表法将其分成观察组与对照组,观察组32例患者接受重组改构人肿瘤坏死因子+顺铂胸腔灌注治疗;对照组32例患者接受胸腔注入顺铂治疗。结果观察组总缓解率是75.0%(24/32)明显高于对照组的40.6%(13/32),差异具有统计学意义(P<0.05);观察组患者生理职能、情绪职能、认知职能、社会职能、心理健康、角色职能各因子评分明显高于对照组,且总生活质量优于对照组,组间比较差异具有统计学意义(P<0.05)。结论重组改构人肿瘤坏死因子胸腔灌注疗法用于老年肺癌恶性胸腔积液的治疗效果较为满意,改善患者的临床症状,减轻患者承受的痛苦,提高其生存质量,在临床治疗中的实用、推广价值较高。

Objective To study the effect of recombinant mutant human tumor necrosis factor alpha （TNF-α） by intrapleural perfusion in the treatment of malignant pleural effusion in elderly patients with lung cancer. Method 64 patients with advanced lung cancer were enrolled and randomized into either study group or control group according to a random number table; the patients in study group （32 cases） received recombinant mutant TNF-α ＋cisplatin by intra-pleural perfusion; and those in control group had thoracic injection of cisplatin. Result In the study group, the overall response rate （ORR） was 75.0% （24 / 32）, and was higher than the 40.6% （13 / 32） of the control group, which was statistically significant （P〈0.05）. The physiological fimction, emotional function, cognitive function, social function, mental health, role function as well as the overall quality of life in the study group were all higher or better than those of the control group, the difference between the two groups had statistical significance （P〈0.05）. Conclusion The recombinant mutant TNF-α by pleural perfusion therapy is effective in the treatment of elderly lung cancer patients with malignant pleural effusion, and may alleviate patient＇s clinical symptoms, reduce pain severity and improve the quality of life, which is clinically practicable and applicable.