吉西他滨或培美曲塞静脉化疗联合顺铂胸腔灌注在非小细胞肺癌合并恶性胸腔积液中的应用研究

摘要

目的 探究吉西他滨或培美曲塞静脉化疗联合顺铂胸腔灌注对非小细胞肺癌合并恶性胸腔积液患者的疗效.方法 选取非小细胞肺癌合并恶性胸腔积液患者130例,根据治疗方案的不同将患者分为观察组与对照组,每组各65例.观察组患者接受培美曲塞静脉化疗联合顺铂胸腔灌注治疗,对照组患者接受吉西他滨静脉化疗联合顺铂胸腔灌注治疗.观察比较两组患者治疗前后白细胞计数(WBC)、血小板计数(PLT)、谷丙转氨酶(ALT)水平、癌胚抗原(CEA)水平、治疗效果、胸腔积液改善情况及不良反应发生率.结果 治疗前,两组患者的WBC、PLT、ALT及CEA水平比较,差异均无统计学意义(P﹥0.05);治疗后,观察组患者的WBC、PLT水平均高于对照组,ALT、CEA水平均低于对照组,差异均有统计学意义(P﹤0.05);治疗过程中,观察组患者的皮疹、口腔炎及蛋白尿发生率均低于对照组(P﹤0.05);观察组患者的治疗效果及胸腔积液改善情况均优于对照组(P﹤0.05).结论 培美曲塞静脉化疗联合顺铂胸腔灌注治疗非小细胞肺癌合并恶性胸腔积液的骨髓抑制及肾毒性较轻,可明显改善胸腔积液情况及疗效,且其他不良反应发生率低.%Objective To explore the effect of intravenous gemcitabine or pemetrexed combined with cisplatin infu-sion for patients with non-small cell lung cancer (NSCLC) and malignant pleural effusion. Method 130 cases of NSCLC with malignant pleural effusion were included in the study,and were assigned as study group or control group ac-cording to respective treatment regimen,each had 65 patients.The patients in study group were treated with intravenous pemetrexed and cisplatin, while patients of control group received intravenous gemcitabine plus cisplatin infusion, the white blood cell(WBC),platelet count(PLT),alanineamino transferase(ALT),carcino-embryonic antigen(CEA),cura-tive effect,pleural effusion improvement and adverse reactions were observed and compared.Result There was no sig-nificant differences in WBC,PLT,CEA and ALT between the two groups before treatment(P>0.05);after treatment,the WBC and PLT of the study group were higher than those of the control group,but ALT and CEA were lower than that of the control group,the differences were statistically significant(P<0.05);during the treatment,the incidence of rash,sto-matitis and proteinuria of the study group were lower than those in the control group(P<0.05).The curative effect and the improvement of pleural effusion of the study group were better than those of the control group(P<0.05).Conclusion In-travenous pemetrexed combined with cisplatin infusion induces mild bone marrow suppression and nephrotoxicity when applied in the treatment for patients with non-small cell lung cancer combined with malignant pleural effusion,and the in-cidence of other adverse reactions is at a low level.