顺铂及IL-2胸腔灌注联合全身化疗治疗肺癌恶性胸腔积液

Clinical observation on intrapleural administration of cisplatin and IL-2 combined with systemic chemotherapy in the treatment of malignant pleural effusion of lung cancer

目的 探讨顺铂（DDP）、白细胞介素-2（IL-2）胸腔灌注联合全身化疗治疗肺癌恶性胸腔积液的疗效及对血清肿瘤标志物水平的影响.方法 选择郑州大学第一附属医院2015年1月至2016年12月诊治的96例肺癌胸腔积液患者,根据治疗方法将患者分为观察组（51例）和对照组（45例）.两组均进行胸腔置管引流,对照组予以DDP胸腔灌注并紫杉醇类或依托泊苷（VP-16）静脉化疗,观察组在对照组治疗基础上加IL-2胸腔灌注.比较两组患者胸腔积液有效率、进展时间、肿瘤标记物水平与疗效的关系及两组不良反应发生率.结果 治疗后,对照组与观察组疗效比较差异未见统计学意义（P〉0.05）,两组患者胸腔积液进展时间延长（P〈0.05）.观察组治疗后糖类抗原125、癌胚抗原、神经元特异性烯醇化酶、水溶性细胞角蛋白19片段（Cyfra21-1）水平均低于对照组（P均〈0.05）.两组不良反应发生率比较差异未见统计学意义（P〉0.05）.结论 在肺癌恶性胸腔积液的治疗中,顺铂、IL-2胸腔灌注联合全身化疗在不增加药物不良反应的前提下,显著降低了肿瘤标记物水平,提高了胸腔积液治疗有效率,并且延长了胸腔积液进展的时间.

Objective To evaluate the clinical efficacy of intrapleural administration of cisplatin （DDP） and interleukin-2 （IL-2） combined with systemic chemotherapy on malignant pleural effusion of lung cancer and its influence on levels of tumor markers .Methods Ninety-six patients with lung cancer associated with pleural effusion who were treated in the First Affiliated Hospital of Zhengzhou University from January 2015 to December 2016 were selected and divided into observation group （51 cases） and control group （45 cases） according to treatment protocols .All patients were given thoracic cavity catheter drainage;while patients in control group were given intrapleural DDP and intravenous chemotherapy , and patients in observation group were given intrapleural DDP plus IL-2 perfusion and intravenous chemotherapy .The disease control rate , pleural effusion progress free survival , the relationship between tumor markers level and efficacy , and incidence of adverse reactions were compared between the two groups .Results After treatment , there was no significant difference in clinical efficacy between control group and observation group （ P〉0.05 ） .The duration of pleural effusion was prolonged in both groups , and the difference between the two groups was statistically significant （ P〈0.05 ） .The levels of cancer antigen , carcinoembryonic antigen , neuron-specific enolase and Cyfra 21-1 in observation group were significantly lower than those in control group （ P 〈0.05 ） .There was no significant difference in the incidence of adverse reactions between the two groups （ P〉0.05 ） .Conclusions In the treatment of malignant pleural effusion of lung cancer , intrapleural DDP plus IL-2 combined with systemic chemotherapy can reduce levels of tumor marker , further improve clinical efficacy and prolong pleural effusion progress free survival without any increase in adverse reactions .