目的：观察比较胸腔灌注紫杉醇和顺铂治疗乳腺癌恶性胸腔积液的疗效、生活质量及不良反应。方法52例确诊为乳腺癌伴恶性胸腔积液患者，经胸膜腔置管引流术排尽积液后，随机分为紫杉醇组和顺铂组，每组26例。紫杉醇组：胸腔内注射生理盐水50 ml+紫杉醇120 mg+地塞米松10 mg；顺铂组：胸腔内注射生理盐水50 ml+顺铂60 mg+地塞米松10 mg。均为每周1次，连用2周，观察疗效及不良反应。结果紫杉醇组有效率为80．8%，顺铂组有效率61．5%( P<0．05)。治疗后不良反应，胸痛以紫杉醇组明显( P<0．05)，消化道反应以顺铂组明显( P<0．05)。结论紫杉醇胸腔内注射治疗恶性胸腔积液疗效满意，不良反应可耐受。%Objective To evaluate the efficacy, the quality of life and toxicity of paclitaxel and cisplatin by pleural perfu-sion in patients with malignant pleural effusion derived from breast cancer. Method Fifty-two patients with histologically proved malignant pleural effusion secondary to breast cancer after chest drainage were randomized into paclitaxel group ( A) or cisplatin group (B), with 26 cases in each. Group A was administered with paclitaxel (120 mg) +dexamethasone (10 mg) diluted in 50 ml normal saline, and group B received cisplatin (60 mg) +dexamethasone (10 mg) through pleural perfusion weekly for 2 con-secutive weeks. All patients were assessable for efficacy and toxicity. Result The response rate in group A was significantly dif-ferent from that in group B (88. 5% vs 61. 5%, P < 0. 05). For the adverse reactions, incidence of chest pain was higher in group A (P<0. 05), while the gastrointestinal disorders were more in group B (P<0. 05). Conclusion Pleural perfusion with paclitaxel injection is effective, and well tolerated in the treatment of malignant pleural effusion derived from breast cancer.
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