晚期非小细胞肺癌合并胸水的治疗

The treatment of advanced non-small cell lung cancer complicating hydrotfaorax

目的 探讨非小细胞肺癌合并胸水的临床治疗方法和疗效。方法 晚期非小细胞肺癌TNM ⅢB～Ⅳ期合并胸水患者共67例,按治疗方法随机分为二组,A组:胸腔灌注顺铂和胞必佳+CAP联合方案化疗;B组:单纯胸腔灌注顺铂(PPD)和胞必佳,前瞻性对比研究其疗效。结果 A组在控制肺瘤及胸水、改善肺不张、缓解临床症状、生存质量Karnofsky积分的升高及中位生存期延长方面均优于B组,差异有显著性。结论 胸腔灌注+联合化疗的方法对晚期肺癌合并胸水的治疗效果优于单纯胸腔灌注,同时也存在着相当的不良反应,有待于进一步改善。

Objective To investigate the clinical therapeutic method and its efficacy for advanced non-small cell lung cancer (NSCLC) complicating hydrothorax. Methods 67 cases of NSCLC at TMN stage III b- IV complicating hydrothorax were randomized into two groups according to the therapeutic method. Group A treated with CAP chemotherapy combining with pleural infusion of Cisplatin and Lyophixed nocardia rubra-cell wall skelel-on. Group B treated with simple pleura! infusion in the same way. The effect of the two groups was compared pro-spectively. Results Group A was more effective than group B in controlling hydrothorax and the tumor, improving the pulmonary atelectasis and the clinical symptoms and the Quality of life, improving Kamofsky' s scales and prolonging median survival. It was a significant difference between the two groups. Conclusion It is more effective to treat the advanced NSCLC complicating hydrothorax with combination of pleural infusion and CAP chemotherapy. The related side-effect would be improved.