恩度联合顺铂胸腔内灌注治疗非小细胞肺癌大量恶性胸腔积液的临床观察

Clinical study of intrathoracic perfusion of endostar combined with cisplatin in the treatment of non-small cell lung cancer complicated with massive malignant pleural effusion

目的观察恩度联合顺铂治疗非小细胞肺癌(NSCLC)合并大量恶性胸腔积液(MPE)的疗效和安全性。方法选取NSCLC合并大量MPE患者40例,随机分为恩度顺铂组和顺铂单药组,充分引流胸腔积液后分别胸腔内灌注重组人血管内皮抑制素(恩度)联合顺铂和顺铂单药,比较两组的近期疗效、客观有效率(ORR)、疾病进展时间(TTP)、生活质量(QOL)及不良反应。结果恩度顺铂组的近期疗效和QOL均优于顺铂单药组(P<0.05),ORR高于顺铂单药组(P<0.05);恩度顺铂组TTP为139 d,长于顺铂单药组的55 d(P<0.05)。两组不良反应总发生率的差异无统计学意义(P>0.05)。结论恩度联合顺铂胸腔内灌注治疗非小细胞肺癌合并大量胸腔积液可提高近期疗效,延长TTP,改善QOL,且不增加毒副反应,值得临床进一步推广。

Objective To explore the efficacy and safety of endostar combined with cisplatin in the treatment of non-small cell lung cancer(NSCLC) complicated with massive malignant pleural effusion(MPE). Methods A total of 40 patients with NSCLC complicated with massive MPE were selected and randomly divided into two groups: Combination Group(20 cases) and Cisplatin Group(20 cases). After full drainage of pleural effusion, the Combination Group underwent intrathoracic perfusion of endostar combined with cisplatin while the Cisplatin Group underwent intrathoracic perfusion of cisplatin. The two groups were compared in terms of short-term curative effect, objective response rate(ORR), time to disease progression(TTP), quality of life(QOL) and adverse reactions. Results The Combination Group had the short-term curative effect and QOL superior to the Cisplatin Group(Hc=4.928, P<0.05) and the ORR higher than the Cisplatin Group(P<0.05). The TTP of the Combination Group was 139 d, which was longer than that in the Cisplatin Group(55 d), and the difference was statistically significant(P<0.05). There was no significant difference in the overall incidence of adverse reactions between the two groups(P>0.05). Conclusion Intrathoracic perfusion of endostar combined cisplatin in the treatment of NSCLC combined with massive MPE can improve the short-term curative effect, lengthen the TTP and improve the QOL without increasing the toxic and side effects. It is worthy of further clinical promotion.