热灌注化疗治疗恶性胸腔积液的临床观察

Hyperthermo-Chemotherapy of Intrapleural Perfusion for Malignant Pleural Effusion

目的 探讨热灌注化疗治疗恶性胸腔积液的临床疗效。方法 将经病理或胸腔积液细胞学、染色体检查确诊恶性胸腔积液 2 6例 ,随机分为 2个组 ,治疗组 12例 ,对照组 14例。经胸腔闭式引流术排尽胸腔积液后 ,治疗组行胸腔内热灌注化疗 ,而对照组仅行胸腔内化疗 ,观察胸腔积液量的变化情况、Karnofsky评分、患者生存期以及不良反应。 结果 治疗组总有效率为 91.7%( 11/ 12 ) ;对照组为 5 0 .0 % ( 7/ 14 ) ,有显著性差异 (P <0 .0 5 )。治疗后Karnofsky评分≥ 70分者所占比率 ,治疗组 ( 66.7% ,8/ 12 )显著高于对照组 ( 2 1.4% ,3 / 14 ) (P <0 .0 5 )。治疗组发热发生率 ( 5 0 .0 % ,6/ 12 )高于对照组 ( 7.1% ,1/ 14 ) ,有显著性差异 (P <0 .0 5 )。结论 胸腔内热灌注化疗治疗恶性胸腔积液是 1种有效的、不良反应轻。

Objective To evaluate the efficacy of hyperthermo-chemotherapy of intrapleural perfusion for malignant pleural effusion.Methods 26 cases with malignant pleural effusion were randomly divided into two group.After exhansting effusion from pleural cavity through closed drainage,12 cases were treated with hyperthermo-chemotherapy of intrapleural perfusion[cisplatine(DDP) 60～80 mg/m 2] and 14 cases were treated with intrapleural perfusion(DDP 60～80 mg/m 2) as control.Then the treatment effect,survival rate,toxicities and quality of life were assessed.Results The response rate was 91.7%(11/12) in treated group and 50.0%(7/14) in the control group(P<0.05).The patients with Karnofsky score≥70 were more in treated group(8/12) than in control group(3/14)(P<0.05).The fever was more frequently happened in therapy group(6/12) than in control group(1/14)(P<0.05). Conclusion Hyperthermo-chemotherapy of intrapleural perfusion for malignant pleural effusion is an effective and well tolerated method for the malignant pleural effusion with slight side-effect.