摘要目的 观察胸腔灌注奈达铂(NDP)与顺铂(DDP)治疗非小细胞肺癌(NSCLC)恶性胸腔积液的疗效、患者的牛活质量及毒副反应.方法 68例确诊为NSCLC(湿性Ⅲb期)的患者,经胸腔置管引流术排尽积液后,随机分为NDP组和DDP组,每组34例.NDP组采用NDP 40 mg/m2和氟美松10 mg溶于40 ml生理盐水,胸腔内灌注;DDP组采用DDP 40 mg/m2和氟美松10 mg溶于40 ml生理盐水,胸腔内灌注.每周1次,连续2～4周.两组患者均给予相同常规支持对症治疗,观察并比较各组的疗效、毒副反应及患者的生活质量.结果 NDP组有效率为88.2%,DDP组有效率为61.7%(P<0.01).NDP组消化道不良反应发生率为5.0%,DDP组消化道不良反应发生率为12.9%,差异有统计学意义(P<0.05).NDP组的Karnofsky评分较DDP组有显著提高(P<0.05),NDP组的患者生存期较DDP组显著延长.结论 NDP胸腔灌注治疗NSCLC引起的恶性胸腔积液是一种有效且毒副反应轻的方法 .

abstractsObjective To compare the therapeutic effects of pleural perfusion of NDP and cDDP in non-small cell lung cancer ( NSCLC) patients with malignant pleural effusion, their quality of life and toxic side effects. Methods Sixty-eight NSCLC patients with malignant pleural effusion after chest drainage were randomly divided into two groups according to the pathological types: 34 cases in the NDP (Group A) and cDDP groups (Group B) , 34 cases each.They were treated with NDP (40 mg/m2) and dexamethasone (10 mg) dissolved in 40 ml normal saline, or cDDP (40 mg/m2) and dexamethasone (10 mg ) dissolved in 40 ml of normal saline, respectively, through pleural perfusion weekly for 2-4 weeks. Routine and symptomatic treatment was used in all the patients.The therapeutic effects, life quality and toxic side effects were evaluated. Results The response rates of groups A and B were 88.23% and 61.7% , respectively, ( P < 0.01). The rates of toxic side effects in groups A and B were 39.6% and 41.9% , respectively, (P > 0.05 ). However, the rates of gastrointestinal side effects of the two groups were 5% and 12. 9% , respectively, ( P < 0.05).The Karnofsky scores of group A were higher than that in group B (P < 0. 05). The survival time of group A was significantly longer than that of group B. Conclusion Pleural perfusion with NDP is a good treatment method with milder toxicity for patients with malignant pleural effusion caused by NSCLC.