多西他赛在控制晚期非小细胞肺癌恶性胸腔积液的疗效和安全性评估(1)
摘 要：目的 研究多西他赛在控制晚期非小细胞肺癌恶性胸腔积液的疗效和安全性。方法 将2016年1月～12月本院接收的晚期非小细胞肺癌恶性胸腔积液患者152例，根据按照电脑随机分组原则分为两组，每组76例。两组均行胸腔穿刺术，对照组给予培美曲塞，观察组给予多西他赛治疗。将两组患者的临床疗效、不良反应发生情况和ECOG评分进行比对。结果 观察组晚期非小细胞肺癌恶性胸腔积液患者的临床总有效率89.47%，高于对照组的65.79%，差异有统计学意义(P<0.05)；胃肠道反应、胸痛、肾毒性不良反应的发生率和治疗后ECOG评分均低于对照组，差异有统计学意义(P<0.05)。结论 多西他赛应用在晚期非小细胞肺癌恶性胸腔积液患者中取得疗效确切，临床安全性较高。
关键词：晚期非小细胞肺癌；恶性胸腔积液；多西他赛；安全性
中图分类号：R734.2 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.15.042
, http://www.100md.com
文章编号：1006-1959(2018)15-0132-03
Efficacy and Safety of Docetaxel in the Control of Malignant Pleural Effusion in Patients with Advanced Non-small Cell Lung Cancer
ZHU Shu-juan
(Department of Oncology，Jiamusi Cancer Hospital，Jiamusi 154007，Heilongjiang，China)
Abstract：Objective To study the efficacy and safety of docetaxel in the control of malignant pleural effusion in patients with advanced non-small cell lung cancer.Methods 152 patients with malignant pleural effusion of advanced non-small cell lung cancer received in our hospital from January to December 2016 were divided into two groups according to the principle of computer random grouping，76 cases in each group.Thoracic puncture was performed in both groups，pemetrexide was given in control group and docetaxel was given in observation group.The clinical efficacy，adverse reaction and ECOG score were compared between the two groups.Results The total effective rate of the patients with malignant pleural effusion of non-small cell lung cancer in the observation group was 89.47%，which was higher than that of the control group 65.79%，the difference was statistically significant(P<0.05).The incidence of gastrointestinal reactions，chest pain and nephrotoxic adverse reactions and the ECOG score after treatment were lower than those of the control group，the difference was statistically significant(P<0.05).Conclusion Docetaxel is effective and safe in the treatment of advanced non-small cell lung cancer with malignant pleural effusion.
, 百拇医药
Key words：Advanced non-small cell lung cancer；Malignant pleural effusion；Docetaxel；Safety
非小细胞肺癌(non-small cell lung cancer，NSCLC)是临床恶性肿瘤中较为多见的一种[1，2]，恶性程度高，且在发现时，大部分患者已处于局部晚期或者是已发生远处转移，预后效果差。恶性胸腔积液是该病的晚期症状，若未及时治疗该病，会在短时间内危及患者的生命安全[3]。临床上一般采用姑息性疗法治疗晚期非小细胞肺癌，其中胸腔灌注化疗药物是临床上较为常用的局部化疗方法，药代动力学优势明显且有助于局部肿瘤部位药物浓度的提高，能够降低不良反应发生率。培美曲塞、紫杉醇、多西他赛、顺铂等均是常用于治疗晚期非小细胞肺癌恶性胸腔积液的化疗药物，择取2016年1月～12月我院收治的晚期非小细胞肺癌恶性胸腔积液患者152例，给予培美曲塞、多西他赛治疗对比，现报道如下。
1资料与方法
, http://www.100md.com
1.1一般资料 选取2016年1月～12月佳木斯肿瘤医院收治的晚期非小细胞肺癌恶性胸腔积液患者152例，本次研究经过医院伦理委员会批准。纳入标准：①所有患者均经胸部B超、病理診断明确诊断为晚期非小细胞肺癌；②经细胞学检查确诊为恶性胸腔积液；③患者同意本次研究并签署知情同意书。排除标准：①存在肾功能不全和电解质紊乱的患者；②心电图检查显示异常的患者；③在入组前半年内前接受过放化疗或者是胸腔内注射内药物的患者；③预计生存期在3个月内的患者。根据电脑随机分组原则分为对照组和观察组，每组76例。观察组男性28例，女性48例，年龄52～77岁，平均年龄(62.42±3.85)岁。病理类型：腺癌28例，鳞癌44例，腺鳞癌4例；TNM分期：Ⅲb58期，Ⅳ期18例；X线胸片检查证实胸腔积液中量28例，大量10例。对照组男性32例，女性44例；年龄53～76岁，平均年龄(62.50±3.91)岁。病理类型：腺癌32例，鳞癌42例，腺鳞癌2例；TNM分期：Ⅲb期54例，Ⅳ期22例；X线胸片检查证实胸腔积液中量52例，大量24例。两组患者一般资料对比，差异无统计学意义(P>0.05)，具有可对比性。, 百拇医药(朱淑娟)
关键词：晚期非小细胞肺癌；恶性胸腔积液；多西他赛；安全性
中图分类号：R734.2 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.15.042
, http://www.100md.com
文章编号：1006-1959(2018)15-0132-03
Efficacy and Safety of Docetaxel in the Control of Malignant Pleural Effusion in Patients with Advanced Non-small Cell Lung Cancer
ZHU Shu-juan
(Department of Oncology，Jiamusi Cancer Hospital，Jiamusi 154007，Heilongjiang，China)
Abstract：Objective To study the efficacy and safety of docetaxel in the control of malignant pleural effusion in patients with advanced non-small cell lung cancer.Methods 152 patients with malignant pleural effusion of advanced non-small cell lung cancer received in our hospital from January to December 2016 were divided into two groups according to the principle of computer random grouping，76 cases in each group.Thoracic puncture was performed in both groups，pemetrexide was given in control group and docetaxel was given in observation group.The clinical efficacy，adverse reaction and ECOG score were compared between the two groups.Results The total effective rate of the patients with malignant pleural effusion of non-small cell lung cancer in the observation group was 89.47%，which was higher than that of the control group 65.79%，the difference was statistically significant(P<0.05).The incidence of gastrointestinal reactions，chest pain and nephrotoxic adverse reactions and the ECOG score after treatment were lower than those of the control group，the difference was statistically significant(P<0.05).Conclusion Docetaxel is effective and safe in the treatment of advanced non-small cell lung cancer with malignant pleural effusion.
, 百拇医药
Key words：Advanced non-small cell lung cancer；Malignant pleural effusion；Docetaxel；Safety
非小细胞肺癌(non-small cell lung cancer，NSCLC)是临床恶性肿瘤中较为多见的一种[1，2]，恶性程度高，且在发现时，大部分患者已处于局部晚期或者是已发生远处转移，预后效果差。恶性胸腔积液是该病的晚期症状，若未及时治疗该病，会在短时间内危及患者的生命安全[3]。临床上一般采用姑息性疗法治疗晚期非小细胞肺癌，其中胸腔灌注化疗药物是临床上较为常用的局部化疗方法，药代动力学优势明显且有助于局部肿瘤部位药物浓度的提高，能够降低不良反应发生率。培美曲塞、紫杉醇、多西他赛、顺铂等均是常用于治疗晚期非小细胞肺癌恶性胸腔积液的化疗药物，择取2016年1月～12月我院收治的晚期非小细胞肺癌恶性胸腔积液患者152例，给予培美曲塞、多西他赛治疗对比，现报道如下。
1资料与方法
, http://www.100md.com
1.1一般资料 选取2016年1月～12月佳木斯肿瘤医院收治的晚期非小细胞肺癌恶性胸腔积液患者152例，本次研究经过医院伦理委员会批准。纳入标准：①所有患者均经胸部B超、病理診断明确诊断为晚期非小细胞肺癌；②经细胞学检查确诊为恶性胸腔积液；③患者同意本次研究并签署知情同意书。排除标准：①存在肾功能不全和电解质紊乱的患者；②心电图检查显示异常的患者；③在入组前半年内前接受过放化疗或者是胸腔内注射内药物的患者；③预计生存期在3个月内的患者。根据电脑随机分组原则分为对照组和观察组，每组76例。观察组男性28例，女性48例，年龄52～77岁，平均年龄(62.42±3.85)岁。病理类型：腺癌28例，鳞癌44例，腺鳞癌4例；TNM分期：Ⅲb58期，Ⅳ期18例；X线胸片检查证实胸腔积液中量28例，大量10例。对照组男性32例，女性44例；年龄53～76岁，平均年龄(62.50±3.91)岁。病理类型：腺癌32例，鳞癌42例，腺鳞癌2例；TNM分期：Ⅲb期54例，Ⅳ期22例；X线胸片检查证实胸腔积液中量52例，大量24例。两组患者一般资料对比，差异无统计学意义(P>0.05)，具有可对比性。, 百拇医药(朱淑娟)