Tsubouchi Hitoshi, Tokuda Kouki, Shimana Akihiko, Fukushima Kouhei
Dept. of Surgery, Kobayashi Municipal Hospital.
Gan To Kagaku Ryoho. 2006 Nov;33(11):1629-32.
Carcinomatous pleuritis frequently undermines the quality of life in advanced malignant disease patients. The traditional treatment for pleural effusion is intrapleural administration of a chemical agent, but its efficacy was not at all satisfactory. Ichinose et al.developed hypotonic cisplatin treatment for patients with carcinomatous pleuritis in 1993, and its therapeutic efficacy was assessed by the Japan Clinical Oncology Group. This treatment was performed on seven patients in our hospital since 2002: five patients with non-small-cell lung cancer, one with transverse colon cancer who had myocardial infarction (grade 4) after treatment, and another with gastric cancer who had grade 4 hemosputa. These patients, aged 52 to 88, complained of dyspnea before treatment, but all of them were able to be discharged with control of pleural effusion including the above-mentioned two patients. Although six patients had already died of disease, survival time after treatment of all patients ranged from 96 to 610 days, with an average of 346.7+/-228.2 days. The average time in five patients with non-small-cell lung cancer was longer than that in two with gastrointestinal malignant disease (not significant statistically). Hypotonic cisplatin treatment seemed to enhance the quality of life in lung cancer patients with carcinomatous pleuritis.
癌性胸膜炎常常会损害晚期恶性疾病患者的生活质量。传统的胸腔积液治疗方法是胸腔内注射化学药物,但其疗效并不令人满意。1993年,市之濑等人开发了低渗顺铂治疗癌性胸膜炎患者的方法,其治疗效果由日本临床肿瘤学会进行评估。自2002年以来,我院对7例患者进行了这种治疗:5例非小细胞肺癌患者,1例横结肠癌患者在治疗后发生心肌梗死(4级),另1例胃癌患者出现4级咯血。这些患者年龄在52至88岁之间,治疗前均有呼吸困难症状,但包括上述2例患者在内的所有患者在胸腔积液得到控制后均得以出院。尽管有6例患者已经死于疾病,但所有患者治疗后的生存时间为96至610天,平均为346.7±228.2天。5例非小细胞肺癌患者的平均生存时间长于2例胃肠道恶性疾病患者(统计学上无显著差异)。低渗顺铂治疗似乎提高了患有癌性胸膜炎的肺癌患者的生活质量。