卡铂联合力尔凡治疗恶性胸腔积液的临床研究

Clinical study of carboplatin in combined with lifein for malignant pleural effusions

目的 :恶性胸腔积液是恶性肿瘤患者晚期常见的并发症 ,单纯抽液容易复发 ,胸腔内注入抗癌药物是提高疗效的有效方法。卡铂和力尔凡均为治疗恶性积液的有效药物 ,我们应用这两种药物 ,以评价其治疗恶性胸腔积液的疗效和毒性。方法 :6 0例恶性胸腔积液随机分为两组 ,A组单用卡铂 ,B组卡铂与力尔凡联合应用。结果 :在治疗的第一个月 ,A组CR率 81%,B组CR率 88%;3个月后A组CR率为 6 5 %,B组CR率为 99%,两组差异均无显著性 (P >0 .0 5 ) ;6个月后CR率 ,A组为4 0 %,B组为 6 0 %,两组差异有显著性 (P <0 .0 5 )。 6个月生存率两均为 10 0 %(P >0 .0 5 ) ,12个月后CR率A组为 15 %,B组为 35 .6 %(P <0 .0 5 ) ;18个月生存率A组为 0 ,B组为 16 .4 %(P <0 .0 5 )。两组不良反应主要有低热、胸痛、胃肠道反应 ,经对症处理可缓解。结论 :卡铂联合力尔凡治疗恶性胸腔积液的疗效明显高于单药卡铂。

Objective: Malignant pleural is a common complication for cases of late stage malignant tumor, with single draining of the pleural cavity by theoracocentesis, the cases mostly have a relapse. Medicine against cancer administered into intracavity in an effective method to improve the curative effective medicine for the treatment of malignant pleural effusion. They were combined to be administered in order to evaluate their effects and toxi cities. Methods: Sixty patients with malignant pleural effusion were randomized into administered; In group A, only corboplatin was administered; In group B, Lifein and carboplatin were combined together to be administered. Result: In the first month posteriorly to treatment, the rate of Cr was 81% in group A, 88% in group B, After three moths 65% in group A, 99% in group B ((P>0.05). After 6-months the rate of CR was 40% in group A, 60% in group B (P<0.05). The 6-month survival rate were both 100% in group A and in group B (P>0.05). After 12 month, Cr rate was 15% in group A, 35.6% group B (P<0.05). The 18-month survival rate were 0% in group A, 16.4%in group B .The main adverse reactions were gastroentevic tract reaction, thoracodynin, and low fever which could be controlled. Conclusion: The curative effect of carboplatin combined with Lifein in the treatment of malignant pleural effusion is apparently superior to that of single carboplatin.