重组人血管内皮抑素联合顺铂治疗恶性胸、腹腔积液的临床观察

摘要

Objective To observe the clinical efficacy of endostar combined with cisplatin in the treatment of malignant hydrothorax and ascites. Methods Endostar combined with cisplatin( combined group )was applied in 42 cases of patients with malignant hydrothorax and ascites. 40 cases of patients with malignant hydrothorax and ascites treated by cisplatin( control team ). Following a maxnium release of hydrothorax and ascites, endostar and cisplatin or cisplatin were injected,to evaluate recent efficacy and toxicity. Results Among 42 cases ( combined group ),there were 18 cases achieved CR,20 cases of PR,objective efficiency rate was 90.4 ％. Among 40 cases( control group ), 39 cases of patients were found to improve their quality of life( 92.9 ％ ), control group was 75％ ,there was significant differences between two groups( P=0.018 ). 36 cases of patients with the increased level of VEGF, decrease of ≥ 25 ％ of the baseline had a significantly better response rate and QOL improvement rate than patients with a decrease of ＜ 25 ％ ( P=0.027, P=0. 006 ). In two groups, the occurrence rates of G3/4 toxicities were mainly beacause of cisplatin, including nausea, vomiting and fatigue, there was no significant differences of them. Conclusion Endostar combined with cisplatin can better control the malignant hydrothorax and ascites,clinical safety is better, it is worthy of clinical application.%目的 观察重组人血管内皮抑素(恩度)联合顺铂治疗恶性胸腔、腹腔积液的临床效果. 方法 将82例恶性胸、腹腔积液患者引流排净积液后,42例患者注入恩度和顺铂(联合组);40例患者注入顺铂单药(对照组),观察疗效及不良反应. 结果 联合组42例患者中,CR 18例,PR 20例,有效率为90.42%;对照组40例患者中,CR 15例,PR 15例,有效率75%,两者差异有统计学意义(P=0.012).在联合组42例患者中,生活质量改善者39例(92.9%);对照组40例患者中生活质量改善者30例(75%),两者差异有统计学意义(P=0.018).联合组中36例患者治疗前胸、腹水VEGF水平异常升高,根据其治疗后VEGF下降的比例,将患者分为VEGF下降≥25%组和VEGF下降＜25%组,前者有效率和生活质量改善率显著优于后者(P=0.027,P=0.006).两组不良反应主要以Ⅰ、Ⅱ度恶心、呕吐,疲乏为主,毒性反应两组比较差异均无统计学意义(P=0.6339,P=0.9971). 结论 恩度联合顺铂治疗恶性胸、腹腔积液安全有效,不良反应轻微,可以临床应用.