目的:观察重组人血管内皮抑素(恩度)联合博来霉素胸腔灌注治疗肺癌恶性胸水的近期疗效及不良反应.方法:65例肺癌伴恶性胸水患者经胸腔置中心静脉导管排尽胸水后随机分为3组.A组(BLM组)21例胸腔内灌注博来霉素40-60mg d1,5每3周为一周期；B(恩度组)20例患者胸腔内灌注恩度60mg,每3周一次；C组(恩度+ BLM组)24例胸腔内联合灌注恩度60mg和博来霉素40-60mg d15每3周为一周期.所有患者至少完成2周期.观察3组患者近期疗效及不良反应及Karnofsky评分改善情况.结果:A组有效率为47.6％；B组有效率50.0％；C组83.3％,显著高于A、B两组(P＜0.05).A组Karnofsky评分改善率为52.3％,B组Karnofsky评分改善率为55.0％.C组Karnofsky评分改善率为87.5％,显著高于A、B组(P＜0.05).三组主要副反应为发热,A组发生率23.8％；B组20.0％；C组25.0％,三组之间无显著差异(P＞0.05).结论:重组人血管内皮抑素联合博来霉素置管灌注治疗肺癌恶性胸水有效、安全,值得推广.%To observe the efficacy and toxicity of endostatin and bleomycin on patients with malignant pleurisy effusions caused by lung cancer. Methods: Sixty five patients with malignant pleurisy effusions caused by lung cancer were randomly divided into three groups which were treated differently with bleomycin (A group), endostatin (B group), bleomycin and endostatin (C group). A group was injected by thorax with 40 - 60mg of bleomycin ,day land 5 ;repeated 21 days. B group was injected with 60mg of endostatin, repeated 21 days. C group was injected with 40 - 60mg of bleomycin ( day 1 and 5 ) and 60 mg of endostatin, repeated 21 days. All patients should complete 2 cycles. Results:The effective rates were 47.6% ,50.0% and 83. 3% in A,B,C groups, there was significiant difference( P < 0.05 ). The improvement rates of Karnofsky were 52.3% ,55.0% and 87.5% in 3 groups, there was significiant difference(P<0.05). The main toxicity was fever and the response rates were 23. 8% , 20% and 25.0% (P > 0.05). Conclusion: Endostatin combined with bleomycin were efficient and safe in the treatment of patients with malignant pleurisy caused by lung cancer. It deserves further application.
展开▼
