《癌症》ChineseJournalofCancer,2006,25(4):505—508505VP.16联合DDP心包腔内注射治疗非小细胞肺癌恶性心包积液陈丽昆1,-,徐光川1,2,梁颖1一,杨群英1一,张利娜l,2临床研究IntrapericardialInfusionofEtoposideandCisplatininTreatingMalignantPericardialEffusionofNon-smallCellLungCancerCHENLi—Kunl一,XUGuang—Chuanl一,LIANGYin91一,YANGQun—Yin91一,ZHANGLi—Nal'21.华南肿瘤学国家重点实验室.广东广州5100602.中山大学肿瘤防治中心内科.广东广州510060』.StateKeyLaboratoryofOncologyinSouthChina,Guangzhou,Guangdong,510060,P.尺.(流ina2.DepartmentofMedicalOncology,CancerCenter,SunYat—senUniversity,Guangzhou,Guangdong,510060,尸.R.China通讯作者:陈丽昆Correspondenceto:CHENLi—KunTel:86—20—87343368E—mail:ssnow2005@163.COITI收稿日期:2005—09—19修回日期:2005—10—28[ABSTRACT]BACKGROUND&OBJECTIVE:PericardiocentesisandintraDericardialinfusionofchemotherapeuticdrugsiSthemaintreatmentofmaliqnantpericardiaIeffusion.ThisstudywastoobservetheefficacyandsideeffectoflnlrapericardiaIinfusionofetoposide(VP一16)andcisplatin(DDP)onmalignantpericardialeffusionofnon—smallcelllungcancer(NSCLC).METHODS:Twenty—eightNSCLCpatientswithmalignantpericardialeffusionweretreatedwithpericardiOcentesisandintrapericardiaIinfusionofVP一16(200—300mg)andDDP(80—100mg)Intravenouschemotherapyweregiven2weeksafterthepericardiocentesisRESULTS:TheoveralIresponsefOR)rateofthefirst—timetreatmentofthe28patientswas857%.withcompleteresponse(CR)rateof71.4%:theORrateOfthesecond—timetreatmentwas100%.Only4patientsneededsecond—timeDericardiocentesis.SixteenpatientsdevelopedgastrointestinaItractreaction(mainlygradel—I|),12developedmyeIosuppression(mainlygrade1),and1showedmildabnormaIoftransaminase.Forthe24ndivepatients.theoverallsurvivaItimewas14monthsforstageⅢBand109monthsforstageIV:whereasforthe4patientswithrelapseddisease.theoveralfsurvivaItimewas6months(fromthetimeofrelapse).CONCLUSION:IntrapericardiaIinfusionOfVP一16andDDPiSaneffectivetreatmentformalignantpericardiafeffusionofNSCLCKEYWORDS:Lungneoplasm;Malignantpericardialeffusion;Chemotherapy;Etoposide;Cisplatin【摘要】背景与目的:心包穿刺抽液后心包腔内药物治疗是治疗恶性心包积液的主要手段。本研究观察足叶乙甙(vP一16)联合顺铂(DDP)心包腔内注射治疗非小细胞肺癌恶性心包积液的疗效及不良反应。方法:对28例t1;4,细胞肺癌恶性心包积液的患者行心包穿刺术,尽可能抽尽液体后心包腔内注入vP.16200~300mg和DDP80~t00mg,局部治疗后2周行全身化疗。结果:28例患者首次治疗有效率85.7%,完全缓解率71.4%,2次治疗总有效率100%。仅4例患者需行二次穿刺治疗。治疗后胃肠道反应16例,主要为I~Ⅱ度;骨髓抑制12例,主要为I度;转氨酶轻度升高1例。24例初治患者中,ⅢB期患者中位生存期14个月,Ⅳ期患者中位生存期tO.9个月;复发的4例患者中位生存期6个月(从复发日起计算)。结论:心包穿刺抽液加心包腔内注入VP—16联合DDP是恶性心包积液有效的治疗方法。关键词:肺肿瘤;恶性心包积液;化学疗法;足叶乙甙;顺铂中图分类号:R734.2;R730.53文献标识码:A文章编号:1000—467x(2006)04—0505—04肺癌是引起恶性心包积液最常见的原因。t1;4,细胞肺癌恶性心包积液单纯心包穿刺抽液或引流很容易复发,心包腔内药物治疗是控制恶性心包积液的有效治疗手段。用于心包腔内的药物有硬化剂、化疗万方数据506陈丽昆。等.VP一16联合DDP心包腔内注射治疗非小细胞肺癌恶性心包积液药及免疫制剂。中山大学肿瘤防治中心内科自1999年6月开始对非小细胞肺癌恶性心包积液的患者使用足叶乙甙(VP.16)联合顺铂(DDP)心包腔内注入治疗,并结合全...