实用肿瘤学杂志 ›› 2012, Vol. 26 ›› Issue (3): 228-231.doi: 10.3969/j.issn.1002-3070.2012.03.009

• 论著 • 上一篇    下一篇

深部热、化疗对不同病理类型肺癌所致恶性胸腔积液的疗效观察

徐舒, 赵永心, 龙德   

  1. 广州市中西医结合医院内三科(广州 510800)
  • 收稿日期:2012-01-18 出版日期:2012-06-28 发布日期:2014-12-03
  • 通讯作者: 徐舒,E-mail:selflearner@126.com
  • 作者简介:徐舒,男,(1975-),博士,副主任医师,从事消化道肿瘤的基础与临床研究

Effects of thermotherapy plus intracavitary chemotherapy in the treatment of MPE caused by different lung cancer

XU Shu,ZHAO Yongxin,LONG De   

  1. Department of Oncology,Guangzhou Hospital of Integrated Medicine,Guangzhou 510800
  • Received:2012-01-18 Online:2012-06-28 Published:2014-12-03

摘要: 目的 观察深部热、化疗对肺癌引起的恶性胸腔积液(Malignant pleural effusion,MPE)的疗效及其与病理类型的相关性。方法 将晚期肺癌合并MPE患者根据病理类型分为腺癌组(28例)和鳞癌组(25例),先行胸腔穿刺充分引流后给予博来霉素50 mg+甘露聚糖肽60 mg腔内注射,同时局部热疗。腔内注药1次/周,热疗2~3次/周,2周为一个疗程,一个疗程后给予最佳支持治疗,监测胸水控制情况及KPS评分改善、毒副反应。结果 两组间近期有效率(CR+PR)%无统计学差异(鳞癌组64.0%,腺癌组82.1%,P=0.212);有效控制时间腺癌组优于鳞癌组(58.1±11.9 d vs 45.8±11.5 d,P=0.003);两组间Karnofsky评分改善及毒副反应发生率无显著性差异。结论 深部热、化疗对晚期肺癌MPE有较好的控制作用,其中腺癌患者较鳞癌患者获得更长的有效控制时间;腺癌组KPS改善也有优于鳞癌组的趋势。

Abstract: Objective To evaluate the curative effect of thermotherapy plus intracavitary chemotherapy treating MPE in different lung cancer patients,as well as the toxic and adverse reaction and the influence on Karnofsky performance status.Methods Totally 53 advanced lung cancer patients with MPE were divided into two groups according to pathology,namely adenocarcinoma group and SQCA group.After puncture and drainage of thoracic cavity,intracavitary chemotherapy was subsequently performed by intracavitary administration of Bleomycin and Mannatide once a week.At the same time,thermotherapy was followed twice or thrice a week.After a two-week treatment all patients were given best supporting therapy,and then hydrothorax,Karnofsky performance status and toxic and adverse reactions were monitored.Results There was no significant difference in the recent response rates(64.0% of SQCA group vs.82.1% of adenocarcinoma group,P=0.212),Karnofsky grade improvements and side-effects occurrences between two groups.However,adenocarcinoma group had a longer effective control time than SQCA group with 58.1±11.9d vs 45.8±11.5d,respectively(P=0.003).Conclusion Thermotherapy plus intracavitary chemotherapy can effectively control MPE in advanced lung cancer patients.Among the cases,adenocarcinoma patients may get a longer valid-control-time than SQCA patients.Furthermore,it showed that this group may achieve a better improvement in the Karnofsky performance status.So,pathology is still guidance in the treatment options in the individual-therapy era.

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