Department of Respiratory Diseases, Qilu Hospital, Shandong University, Jinan, China.
Clinical Pharmacological Centre, Qilu Hospital, Shandong University, Jinan, China.
Thorac Cancer. 2018 Aug;9(8):950-955. doi: 10.1111/1759-7714.12768. Epub 2018 Jun 19.
Malignant pleural effusion is a common complication of non-small cell lung cancer (NSCLC); however, treatment options remain limited. This study evaluated the safety and efficacy of sequential intrapleural therapy with lobaplatin and erythromycin for NSCLC-mediated malignant pleural effusion.
Fifty-six patients with NSCLC complicated with malignant pleural effusion were recruited for a prospective single-arm study from December 2014 to 2016; one patient dropped out. In addition to conventional systemic chemotherapy, lobaplatin and erythromycin were intrapleurally injected into subjects. Short and long-term responses were analyzed. The concentration of ultrafilterable platinum in the pleural effusion and plasma were detected at different time points. Incidences of severe adverse reactions were observed.
In the 55 evaluable patients, the effective rate of pleural effusion was 81.8% after six weeks of treatment. Six and twelve months after treatment, the effective rates were 60% and 21.8%, respectively, and the one-year survival rate was 83.6%. The concentrations of lobaplatin in pleural effusion and plasma two hours after injecting 50 mg lobaplatin into the thoracic cavity were 13.763 ± 1.523 μg/mL and 1.120 ± 0.164 μg/mL, and 17 hours later were 1.961 ± 0.351 μg/mL and 0.578 ± 0.095 μg/mL, respectively. The rate of severe adverse reactions of the first cycle of systemic chemotherapy combined with lobaplatin and erythromycin did not significantly differ from the rate in the second cycle.
Intrapleural combination therapy with lobaplatin and erythromycin is a safe and efficient treatment for patients with NSCLC-mediated malignant pleural effusion.
恶性胸腔积液是非小细胞肺癌（NSCLC）的常见并发症；然而，治疗选择仍然有限。本研究评估了洛铂和红霉素序贯胸腔内治疗 NSCLC 所致恶性胸腔积液的安全性和有效性。
2014 年 12 月至 2016 年期间，我们进行了一项前瞻性单臂研究，共招募了 56 例 NSCLC 合并恶性胸腔积液患者；其中 1 例患者脱落。除常规全身化疗外，还向受试者胸腔内注射洛铂和红霉素。分析了短期和长期疗效。在不同时间点检测胸腔积液和血浆中超滤铂的浓度。观察严重不良反应的发生率。
在 55 例可评价患者中，治疗 6 周后胸腔积液有效率为 81.8%。治疗 6 个月和 12 个月后，有效率分别为 60%和 21.8%，1 年生存率为 83.6%。胸腔内注射 50mg 洛铂后 2 小时，胸腔积液和血浆中洛铂的浓度分别为 13.763±1.523μg/mL 和 1.120±0.164μg/mL，17 小时后分别为 1.961±0.351μg/mL 和 0.578±0.095μg/mL。洛铂和红霉素联合全身化疗第一周期的严重不良反应发生率与第二周期无显著差异。
洛铂和红霉素胸腔内联合治疗是治疗 NSCLC 所致恶性胸腔积液的一种安全有效的方法。
