顺铂治疗肺癌胸水的疗效观察

cis-Platin in the Treatment of Pleural Effusion in Patients with Lung Cancer

顺二氨二氯铬铂[Cis-Diamminedich-loroplatinum(Ⅱ)]简称顺铂或CDDPJ为近年合成的广谱抗癌药,国外已广泛用于临床,国内也陆续推广使用,但尚未见用于恶性胸膜渗出的报道。自1980年10月至82年10月,胸膜腔内注入顺铂合并全身小剂量化疗,治疗肺癌胸水共21例,结果如下。临床资料应用山东医科院药研室合成的顺铂治疗单例晚期肺癌胸水共21例。男20例,女1例。平均年龄52岁(30～60)。大量胸水8例,中等量8例,少量5例。胸水或痰检癌细胞全部阳性,其中腺癌14例,未分化癌6例,鳞癌1例。除1例胸水呈淡黄色外,均为血性。治疗方法为每周1次胸穿排液。

Between October 1980 and October 1982, 21 lung cancer patients with pleural effusion were treated with intrapleural instillation of cis-platin (cDDP) together with systemic administration of Vincristine, Endoxan or 5-Fu intravenouly. Diagno- sis in all patients were confirmed cytologically. The objective response rate was 85.7% (18/21), including ten complete response and eight partial response cases. Of the responders, the median duration of remission and median survival were 7.5(range, 3-13.7) and 10 (range, 4-23^+)months respective- ly. The responders′median survival was much longer in cis-Platin-treated group than that in which other chemotherapeutic drugs were instilled (10 vs. 4 months, P< 0.01) and that in which systemic chemotherapy was used only (10 vs. 2.5 months, P<0.01). The main side effects were anorexia, nausea and vomiting, but were tolerable. In a few patients a trace of protein or some red and/or wbc were detected in the urine.