奥沙利铂联合胸腺肽治疗肺癌合并恶性胸腔积液的临床观察
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篇名: 奥沙利铂联合胸腺肽治疗肺癌合并恶性胸腔积液的临床观察
TITLE:
摘要: 目的:观察奥沙利铂联合胸腺肽治疗肺癌合并恶性胸腔积液的疗效和安全性。方法: 120例肺癌合并恶性胸腔积液患者随机分为对照组(60例)和观察组(60例)。两组患者均行胸腔内置管引流术,经B超证实胸腔积液引流干净后行胸腔药物灌注。治疗前1 d开始每晚睡前口服氯雷他定片10 mg,连用1周;灌注药前30 min肌内注射盐酸异丙嗪注射液25 mg预防过敏,肌内注射甲氧氯普胺20 mg预防胃肠道反应;以地塞米松10 mg和2%利多卡因10 ml,加入0.9%氯化钠溶液10 ml中,经引流管注入胸腔内预防和减轻胸痛及发热等胸膜反应症状。在此基础上,对照组患者给予注射用奥沙利铂100 mg/m2,缓慢经引流管注入胸腔;观察组患者在对照组治疗的基础上给予胸腺肽注射液300 mg,缓慢经引流管注入胸腔,用药2 d后引流胸腔积液。两组均每周1次,4周为1个周期,共治疗2个周期。观察两组患者的临床疗效,临床获益率,治疗前后血清T淋巴细胞(CD3+、CD4+、CD8+)、炎症因子[白细胞介素(IL)-6、肿瘤坏死因子(TNF)-α)]水平,随访生存情况及毒副反应发生情况。结果 :观察组患者客观有效率、疾病控制率、临床获益率、生存率均显著高于对照组,毒副反应发生率显著低于对照组,差异均有统计学意义(P<0.05)。治疗后,观察组患者CD3+、CD4+、CD8+水平均显著高于同组治疗前及对照组,两组患者IL-6、TNF-α水平均显著低于同组治疗前,且观察组低于对照组,差异均有统计学意义(P<0.05);对照组患者治疗前后CD3+、CD4+、CD8+水平比较,差异均无统计学意义(P>0.05)。结论: 奥沙利铂联合胸腺肽治疗肺癌合并恶性胸腔积液可提高疗效,延长生存期,提高生存质量,降低毒副反应发生率。
ABSTRACT: OBJECTIVE: To observe the efficacy and safety of oxaliplatin combined with thymosin in the treatment of lung cancer with malignant pleural effusion. METHODS: 120 lung cancer patients with malignant pleural effusion were randomly divided into control group (60 cases) and observation group (60 cases). All patients received chest microtubules drainage, then thoracic cavity drug infusion after clean effusion drainage verified by B ultrasound, 10 mg Loratadine tablet was orally given before going to bed 1 d before drug infusion, for 1 week; 25 mg Promethazine hydrochloride injection was intramuscularly injected 30 min before drug infusion for allergy prevention, 20 mg metoclopramide for gastrointestinal reaction prevention, 10 mg dexamethasone and 10 ml 2%  lidocaine, adding into 10 ml 0.9% Sodium chloride solution, injected to thoracic cavity by drainage tube to prevent and relief chest pain, fever, and other pleural reaction symptoms. Based on it, control group was injected 100 mg/m2 Oxaliplatin for injection to thoracic cavity by drainage tube. Observation group was additionally given 300 mg Thymosin injection, to thoracic cavity by drainage tube. Pleural effusion was drained after 2 d. Once every week in 2 groups, 4-week was regarded as 1 coure,and it lasted 2 courses. Clinical efficacy, clinical benefit rate, and serum T lymphocyte subsets (CD3+,CD4+,CD8+), inflammatory cytokines levels [interleukin (IL)-6, tumor necrosis factor (TNF)-α)] before and after treatment in 2 groups were observed, survival status and the incidence of toxicity reactions were followed-up. RESULTS: The objective response rate, disease control rate, clinical benefit rate, survival rate in observation group were significantly higher than control group, the incidence of toxicity reactions was significantly lower than control group, the differences were statistically significant (P<0.05). After treatment, CD3+, CD4+, CD8+ levels in observation group were significantly lower than before, and observation group was lower than control group, the differences were statistically significant (P<0.05),there were no significant differences in CD3+,CD4+,CD8+ levels before and after treatment in 2 groups(P>0.05). CONCLUSIONS: Oxaliplatin combined with thymosin can improve efficacy in the treatment of lung cancer with malignant pleural effusion, prolong survival period, improve survival quality and reduce the incidence of toxicity reactions.
期刊: 2016年第27卷第27期
作者: 杨明生,任中海
AUTHORS: YANG Mingsheng,REN Zhonghai
关键字: 肺癌;胸腔积液;奥沙利铂;胸腺肽;胸腔灌注;疗效;安全性
KEYWORDS: Lung cancer; Thoracic cavity effusion; Oxaliplatin; Thymosin; Pleural perfusion; Efficacy; Safety
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