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射频热疗联合化疗治疗肺癌所致恶性心包积液的疗效

[Efficacy of radiofrequency hyperthermia combined with chemotherapy in treatment of malignant pericardial effusion caused by lung cancer].

作者信息

Luo Pengfei, Cao Peiguo, Yao Zhiping

机构信息

Department of Medical Oncology, Central South University, Changsha 410013, China.

出版信息

Zhongguo Fei Ai Za Zhi. 2011 Jul;14(7):593-7. doi: 10.3779/j.issn.1009-3419.2011.07.06.

Abstract

BACKGROUND AND OBJECTIVE

Malignant pericardial effusion is one of the serious complications of lung cancer and lack effective treatment methods. The aim of this study is to evaluate the efficacy and safety of radiofrequency hyperthermia combined with chemotherapy for patients with malignant pericardial effusion caused by lung cancer.

METHODS

Fifty-five patients with malignant pericardial effusion caused by lung cancer were divided into hyperthermia combined with chemotherapy group (combined therapy group) and chemotherapy group. The combined therapy group was treated with radiofrequency hyperthermia after the pericardiocentesis and intracavitary injection (cisplatin 20 mg and dexamethasone 5 mg), when patients' general state of health improved, systemic chemotherapy was performed. The chemotherapy group was treated only with intracavitary injection and systemic chemotherapy. Intracavitary chemotherapy was performed for 1-6 times (average 3 times). Hyperthermia was performed twice per week with an average of 6 times following intracavitary and systemic chemotherapy. The temperature of intracavitary was 40.5 °C-41.5 °C for 60 min during the hyperthermia periods. Systemic chemotherapy consists of cisplatin (75 mg/m²) and vinorelbine (50 mg/m²).

RESULTS

The complete remission rate (CR) of malignant pericardial effusion was 54.3% and the response rate (RR) was 91.4% in the combined therapy group, while the rates of CR and RR of chemotherapy group were 25.0% and 70.0%, and the differences of CR and RR between the two groups were significant (P<0.05). After treatment, the quality of life improved significantly in both groups, but the combined therapy group had a higher KPS score than in the chemotherapy group (P<0.05). The adverse events associated with the chemotherapy included gastrointestinal toxicity and myelosuppression, and there were no significant differences between the two groups. The main side effects associated with radiofrequency hyperthermia included local skin ache (8.6%) and induration of subcutaneous fat (5.7%).

CONCLUSIONS

Radiofrequency hyperthermia combined with chemotherapy is effective in treatment of malignant pericardial effusion and can significantly improve the quality of life of patients without increasing the toxicity of chemotherapy, and side effects could be tolerable.

摘要

背景与目的

恶性心包积液是肺癌的严重并发症之一,且缺乏有效的治疗方法。本研究旨在评估射频热疗联合化疗对肺癌所致恶性心包积液患者的疗效及安全性。

方法

将55例肺癌所致恶性心包积液患者分为热疗联合化疗组(联合治疗组)和化疗组。联合治疗组在进行心包穿刺及腔内注射(顺铂20mg和地塞米松5mg)后,待患者一般状况改善时进行射频热疗,然后进行全身化疗。化疗组仅进行腔内注射及全身化疗。腔内化疗进行1 - 6次(平均3次)。热疗每周进行2次,在腔内及全身化疗后平均进行6次。热疗期间腔内温度保持在40.5℃ - 41.5℃,持续60分钟。全身化疗方案为顺铂(75mg/m²)和长春瑞滨(50mg/m²)。

结果

联合治疗组恶性心包积液的完全缓解率(CR)为54.3%,有效率(RR)为91.4%,而化疗组的CR率和RR率分别为25.0%和70.0%,两组CR和RR差异有统计学意义(P<0.05)。治疗后,两组患者生活质量均显著改善,但联合治疗组的KPS评分高于化疗组(P<0.05)。化疗相关不良事件包括胃肠道毒性和骨髓抑制,两组之间无显著差异。射频热疗的主要副作用包括局部皮肤疼痛(8.6%)和皮下脂肪硬结(5.7%)。

结论

射频热疗联合化疗治疗恶性心包积液有效,可显著提高患者生活质量,且不增加化疗毒性,副作用可耐受。

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