热疗联合胸腔内顺铂化疗治疗晚期肺腺癌合并恶性胸腔积液的临床疗效分析(1)
[摘要] 目的 观察热疗联合胸腔内顺铂化疗治疗晚期肺腺癌恶性胸腔积液的疗效与安全性。 方法 将61例晚期肺腺癌合并恶性胸腔积液患者随机分成两组，研究组31例给予胸腔积液置管引流后灌注顺铂化疗及局部胸腔热疗，对照组30例接受胸腔积液置管引流后单纯胸腔内灌注顺铂化疗，比较两组患者的临床疗效及不良反应，并采用KPS评分评价患者的生活质量。 结果 研究组胸腔积液控制客观有效率明显高于对照组(87.1% vs 60.0%，P<0.05)，生活质量的总改善率亦明显优于对照组(83.9% vs 56.7%，P<0.05)。两组毒性反应率比较无统计学差异(P>0.05)。 结论 胸腔热疗联合胸腔内灌注顺铂化疗治疗晚期肺腺癌合并恶性胸腔积液疗效确切，毒副反应轻，能有效改善患者生活质量。
[关键词] 肺腺癌；恶性胸腔积液；胸腔内化疗；顺铂；热疗
[中图分类号] R734.2 [文献标识码] B [文章编号] 1673-9701(2018)16-0060-04
[Abstract] Objective To observe the efficacy and safety of hyperthermia combined with cisplatin for chemotherapy in the treatment of advanced lung adenocarcinoma complicated with malignant pleural effusion. Methods 61 patients with advanced lung adenocarcinoma complicated with malignant pleural effusion were randomly divided into two groups. 31 patients in the study group were given perfusion of cisplatin for chemotherapy and local pleural hyperthermia after catheterization and drainage of pleural effusion. 30 patients in the control group were given pleural effusion with cisplatin alone after catheterization and drainage of pleural effusion. The clinical efficacy and adverse reactions were compared between the two groups， and KPS scores were used to evaluate the quality of life of patients. Results The objective effective rates of the control of pleural effusion in the study group were significantly higher than those in the control group(87.1% vs 60.0%， P<0.05). The overall improvement rate of quality of life was also significantly better than the control group(83.9% vs 56.7%， P<0.05). There was no statistically significant difference in the rate of toxic reactions between the two groups(P>0.05). Conclusion Thoracic hyperthermia combined with intrapleural effusion of cisplatin for chemotherapy in the treatment of advanced lung adenocarcinoma complicated with malignant pleural effusion has an exact curative effect， and the toxic reactions are mild， which can effectively improve the quality of life of patients.
[Key words] Lung adenocarcinoma； Malignant pleural effusion； Intrapleural chemotherapy； Cisplatin； Hyperthermia
惡性胸腔积液(MPE)是指胸膜原发或继发的恶性肿瘤所致的胸膜腔积液。很多恶性肿瘤均可导致MPE的产生。其中肺癌是最常见的肿瘤，约占MPE的1/3[1]。晚期NSCLC患者胸腔积液发生率可达到50%以上，其临床症状严重，预后极差[2，3]。胸腔积液需要及早控制，以改善症状、提高生活质量、延长生存。胸腔积液的治疗目前推荐以胸膜固定术、胸腔持续引流、胸腔内灌注药物等治疗为主[4-7]。研究表明胸腔灌注化疗药物能有效控制胸腔积液产生及相关症状，而热疗与胸腔热灌注化疗具有协同作用[8，9]。我科2015年1月～2017年10月共收治肺腺癌合并恶性胸腔积液患者61例，将患者分为对照组及研究组，对照组行单纯顺铂胸腔灌注化疗，研究组采取胸腔热疗联合顺铂胸腔灌注化疗的方法进行治疗，效果确切，现报道如下。
1 资料与方法
1.1 一般资料, 百拇医药(石志永 娄广媛 古翠萍 宋正波 邵岚 张沂平)
[关键词] 肺腺癌；恶性胸腔积液；胸腔内化疗；顺铂；热疗
[中图分类号] R734.2 [文献标识码] B [文章编号] 1673-9701(2018)16-0060-04
[Abstract] Objective To observe the efficacy and safety of hyperthermia combined with cisplatin for chemotherapy in the treatment of advanced lung adenocarcinoma complicated with malignant pleural effusion. Methods 61 patients with advanced lung adenocarcinoma complicated with malignant pleural effusion were randomly divided into two groups. 31 patients in the study group were given perfusion of cisplatin for chemotherapy and local pleural hyperthermia after catheterization and drainage of pleural effusion. 30 patients in the control group were given pleural effusion with cisplatin alone after catheterization and drainage of pleural effusion. The clinical efficacy and adverse reactions were compared between the two groups， and KPS scores were used to evaluate the quality of life of patients. Results The objective effective rates of the control of pleural effusion in the study group were significantly higher than those in the control group(87.1% vs 60.0%， P<0.05). The overall improvement rate of quality of life was also significantly better than the control group(83.9% vs 56.7%， P<0.05). There was no statistically significant difference in the rate of toxic reactions between the two groups(P>0.05). Conclusion Thoracic hyperthermia combined with intrapleural effusion of cisplatin for chemotherapy in the treatment of advanced lung adenocarcinoma complicated with malignant pleural effusion has an exact curative effect， and the toxic reactions are mild， which can effectively improve the quality of life of patients.
[Key words] Lung adenocarcinoma； Malignant pleural effusion； Intrapleural chemotherapy； Cisplatin； Hyperthermia
惡性胸腔积液(MPE)是指胸膜原发或继发的恶性肿瘤所致的胸膜腔积液。很多恶性肿瘤均可导致MPE的产生。其中肺癌是最常见的肿瘤，约占MPE的1/3[1]。晚期NSCLC患者胸腔积液发生率可达到50%以上，其临床症状严重，预后极差[2，3]。胸腔积液需要及早控制，以改善症状、提高生活质量、延长生存。胸腔积液的治疗目前推荐以胸膜固定术、胸腔持续引流、胸腔内灌注药物等治疗为主[4-7]。研究表明胸腔灌注化疗药物能有效控制胸腔积液产生及相关症状，而热疗与胸腔热灌注化疗具有协同作用[8，9]。我科2015年1月～2017年10月共收治肺腺癌合并恶性胸腔积液患者61例，将患者分为对照组及研究组，对照组行单纯顺铂胸腔灌注化疗，研究组采取胸腔热疗联合顺铂胸腔灌注化疗的方法进行治疗，效果确切，现报道如下。
1 资料与方法
1.1 一般资料, 百拇医药(石志永 娄广媛 古翠萍 宋正波 邵岚 张沂平)
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