上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

贝伐单抗联合顺铂治疗非小细胞肺癌恶性胸腔积液的效果和安全性

陈雷，夏书月   

  1. 沈阳医学院附属中心医院呼吸内科， 沈阳 110024
  • 出版日期:2015-08-28 发布日期:2015-09-30
  • 作者简介:陈雷（1977—）， 男， 主治医师， 学士; 电子信箱: drchenleic@163.com。

Therapeutic effect and safety of bevacizumab combined with cisplatin on malignant pleural effusion of patients with non-small cell lung cancer

CHEN Lei, XIA Shu-yue   

  1. Department of Respiratory， Central Hospital Affiliated to Shenyang Medical College, Shenyang 110024, China
  • Online:2015-08-28 Published:2015-09-30

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摘要：

目的  探讨胸腔内给予贝伐单抗联合顺铂治疗非小细胞肺癌恶性胸腔积液的效果及安全性。方法   54例非小细胞肺癌伴恶性胸腔积液患者根据不同的治疗方案分为单纯顺铂治疗组（对照组，n=26）和贝伐单抗联合顺铂治疗组（联合治疗组，n=28)。对照组方案：顺铂，75 mg/m2，胸腔注射，分成2次,每个周期为21 d。联合治疗组方案：贝伐单抗，5 mg/kg，胸腔注射2次，一个周期为21 d；顺铂的胸腔注射剂量和方法与对照组相同。两组患者均给予全身化学治疗（化疗）。每周期前测定胸腔积液量及胸腔积液中血管内皮生长因子（VEGF）含量，根据胸腔积液控制率和疾病控制率评价疗效。观察治疗过程中不良反应的发生情况。结果  治疗结束后，联合治疗组和对照组胸腔积液控制率分别为85.7%和69.2%，疾病控制率分别为96.4%和80.8%，差异均有统计学意义（P<0.05）。在治疗的各个周期，联合治疗组胸腔积液控制率均显著高于对照组（P<0.05）。与治疗前比较，治疗后联合治疗组和对照组胸腔积液中VEGF含量均有所减少，联合治疗组更为明显（P<0.05）。与对照组比较，联合治疗组无新增及加重的不良反应发生。结论  对于非小细胞肺癌患者的胸腔积液，贝伐单抗联合顺铂胸腔注射是一种有效且安全的治疗方法。

关键词: 胸腔积液, 非小细胞肺癌, 贝伐单抗, 顺铂

Abstract:

Objective  To explore the therapeutic effect and safety of intrathoracic injection of bevacizumab combined with cisplatin on malignant pleural effusion (MPE) of patients with non-small cell lung cancer (NSCLC). Methods  A total of 54 NSCLC patients with MPE were randomly divided into the cisplatin group (control group, n=26) and bevacizumab combined with cisplatin group (combined treatment group, n=28) according to different treatment plans. Patients of the control group received intrathoracic injection of cisplatin of 75 mg/m2 twice and each cycle was 21 d. Patients of the combined treatment group received intrathoracic injection of bevacizumab of 5 mg/kg twice and each cycle was 21 d, and the administration of cisplatin was the same as the control group. Patients of two groups all underwent systemic chemotherapy. The volume of pleural effusion and the level of vascular endothelial growth factor (VEGF) in pleural effusion were measured before each cycle. The therapeutic effect was evaluated according to control rates of pleural effusion and disease. The incidence of adverse reactions during the treatment was observed. Results  The control rates of pleural effusion of the combined treatment group and control group were 85.7% and 69.2% and the control rates of disease were 96.4% and 80.8% after treatment. The differences were statistically significant (P<0.05). The control rate of pleural effusion of the combined treatment group was significantly higher than that of the control group at each stage of treatment (P<0.05). The VEGF levels in pleural effusion of the combined treatment group and control group after treatment were lower than those before treatment and the reduction of pleural effusion of the combined treatment group was more remarkable (P<0.05). Compared with the control group, new or aggravating adverse reactions were not found in the combined treatment group. Conclusion  Intrathoracic injection of bevacizumab and cisplatin is an efficient and safe treatment method for NSCLC patients with malignant pleural effusion.

Key words: malignant pleural effusion, non-small cell lung cancer, bevacizumab, cisplatin