贝伐珠单抗胸腔注射联合PC方案治疗肺腺癌恶性胸腔积液患者临床研究

Clinical Study of Bevacizumab Thoracic Injection Combined with PC Chemotherapy in the Treatment of Lung Adenocarcinoma Patients with Malignant Pleural Effusion

目的:探讨贝伐珠单抗胸腔注射联合培美曲塞二钠、卡铂注射液(PC)方案治疗肺腺癌恶性胸腔积液患者的临床效果。方法:选取肺腺癌恶性胸腔积液患者92例,随机分为2组,各46例。对照组给予贝伐珠单抗静脉输注配合PC方案化疗,观察组给予贝伐珠单抗胸腔注射联合PC方案化疗。比较2组治疗效果、治疗前后外周血T淋巴细胞亚群(CD3^(+)、CD4^(+)、NK细胞)、胸腔积液血管内皮生长因子(VEGF)、癌胚抗原(CEA)、低氧诱导因子-1α(HIF-1α)水平及不良反应发生情况。结果:2组比较,观察组总有效率(65.22%vs 43.48%)、疾病控制率(80.43%vs 60.87%)均高于对照组(P<0.05);治疗结束时观察组CD3^(+)[(55.39±3.36)%vs(51.23±4.11)%]、CD4^(+)[(30.38±3.49)%vs(28.14±2.97)%]、NK[(14.05±2.25)%vs(11.39±2.10)%]高于对照组,胸腔积液VEGF[(320.47±57.49)vs(451.28±65.61)pg·mL^(-1)]、CEA[23.49±3.29)vs(31.12±4.01)ng·mL^(-1)]、HIF-1α[(43.08±6.14)vs(50.14±7.33)ng·mL^(-1)]低于对照组(P<0.05);2组胃肠道反应、骨髓抑制、发热或胸痛发生率无明显差异(P>0.05);观察组不良反应总发生率低于对照组(62.22%vs 84.09%)(P<0.05)。结论:贝伐珠单抗胸腔注射联合PC方案化疗治疗肺腺癌恶性胸腔积液,可改善免疫功能,调节肿瘤相关因子表达,降低不良反应总发生率。

Objective:To explore the clinical effect of bevacizumab thoracic injection combined with Pemetrexed disodium and Carboplatin Injection for injection(PC)regimen in the treatment of lung adenocarcinoma patients with malignant pleural effusion.Methods:92 patients with malignant pleural effusion of lung adenocarcinoma were prospectively selected and divided into groups according to the random number table method,each with 46 cases.The control group was given bevacizumab intravenous infusion combined with PC chemotherapy,and the observation group was given bevacizumab thoracic injection combined with PC chemotherapy.The treatment effects,peripheral blood T lymphocyte subsets(CD3^(+),CD4^(+),NK cells),pleural effusion vascular endothelial growth factor(VEGF),carcinoembryonic antigen(CEA),hypoxia inducible factor-1α(HIF-1α)levels before and after treatment and the occurrence of adverse reactions were compared between the two groups.Results:The total effective rate of the observation group was 65.22%,and the disease control rate was 80.43%,which were higher than the 43.48%and 60.87%of the control group(P<0.05).CD3^(+),CD4^(+),NK cells in the observation group were higher than the control group at the end of treatment.Pleural effusion VEGF,CEA,HIF-1αwere lower than the control group(P<0.05).The incidence of gastrointestinal reactions,bone marrow suppression,fever or chest pain in the observation group was not significantly different from that in the control group(P>0.05);the total incidence of adverse reactions in the observation group was lower than that in the control group.Conclusion:The pleural injection of bevacizumab combined with PC chemotherapy has a significant effect on malignant pleural effusion of lung adenocarcinoma,which can improve immune function,regulate the expression of tumor-related factors,and reduce the overall incidence of adverse reactions.