摘要
目的:恶性胸腔积液是晚期肺癌的常见并发症,全身化疗联合胸腔内药物注射是治疗恶性胸腔积液最常用的方法之一,但存在疗效不稳定、药物毒副反应大等问题。本研究的目的是观察热疗联合化疗治疗恶性胸腔积液的疗效、毒副反应和患者的生活质量。方法:确诊为晚期肺癌所致恶性胸腔积液的初治患者60例,分为热化疗和单纯化疗两组。热化疗组:采用胸腔穿刺置入中心静脉导管术尽可能排尽胸水后,给予吉西他滨1000mg/m2,d1、d8,胸腔注射顺铂40mg/次,隔日1次,共3次。胸腔局部化疗24h后采用TYHP700-Ⅰ体外高频热疗机进行患侧胸腔的深部热疗,根据患者实际耐受情况设定治疗功率300～1000W,治疗时间40～60min,每21天为1周期,共治疗4个周期。单纯化疗组:给予吉西他滨1000mg/m2,d1、d8,胸腔注射顺铂40mg/次,隔日1次,共3次,每21天为1周期,共治疗4个周期。结果:热化疗组控制胸水的总有效率为90.0%,单纯化疗组为66.7%(P=0.024)。两组毒副反应仅见一过性发热、轻度气胸和胸膜反应等。两组生活质量好转率分别为72.0%和40.0%(P=0.013)。结论:采用热疗联合化疗治疗恶性胸腔积液疗效确切,毒副反应小,安全性高。
Objective：Malignant pleural effusion is one of the common complications in patients with advanced lung cancer. Intracavitary injection of drug is a usual method, but it still exhibits unstable efficacy and obvious adverse reaction. The aim of this study is to evaluate the efficacy of hyperthermia combined with intracavitary injection of drug for malignant pleural effusion. Methods： Sixty patients with malignant pleural effusion caused by lung cancer were randomized into two groups after puncture or closed drainage. Thirty patients were treated with hyperthermia combined intrapleural injection of cisplatin and injected with gemcitabine for 4 cycles, the other patients were treated only with intrapleural injection of cisplatin and injected with gemcitabine for 4 cycles. Results ： The response rate of pleural effusion was 90. 0% in the combination group and 66. 7% in the chemotherapy group （P =0. 024）. The quality of life in the combination group was significantly better than that in the chemotherapy group （P = 0. 013 ）. Conclusion： Hyperthermia combined intracavitary injection is effective and secure in treatment of malignant pleural effusion.
出处
《临床肿瘤学杂志》
CAS
2008年第2期137-139,共3页
Chinese Clinical Oncology
关键词
深部热疗
顺铂
吉西他滨
恶性胸腔积液
Hyperthermia
Cisplatin
Gemcitabine
Malignant pleural effusion
