Department of Cardiothoracic Surgery, the Second Affiliated Hospital of Fujian Medical University, Fujian, China.
J BUON. 2020 Nov-Dec;25(6):2643-2649.
To explore the efficacy and safety of thoracic hyperthermia perfusion with recombinant human endostatin plus nedaplatin in the treatment of pleural effusion in patients with advanced non-small cell lung cancer (NSCLC).
A retrospective analysis was conducted on the clinical data of 122 advanced NSCLC patients with pleural effusion, and among them, 61 received thoracic hyperthermic perfusion with recombinant human endostatin (ES) plus nedaplatin (Endostatin group), while the other 61 underwent thoracic hyperthermic perfusion with cisplatin alone (Cisplatin group). The short-term efficacy, changes in the pleural effusion and serum immunological indicators before and after treatment, quality of life, and incidence of adverse reactions were compared between the two groups of patients. Finally, the progression of pleural effusion in patients were followed up and recorded.
After treatment, the overall response rate of patients in Endostatin group was considerably higher than that in Cisplatin group (p=0.030). At 2 weeks after treatment, the level of alanine transferase (ALT) rose notably, while that of carcinoembryonic antigen (CEA) declined dramatically in both groups of patients, and the patients in Endostatin group had markedly lower levels of ALT and CEA than those in Cisplatin group (p=0.007, p=0.003). After treatment, the Karnofsky Performance status (KPS) score of patients was prominently raised in the two groups, and Endostatin group exhibited considerably higher KPS scores than Cisplatin group (p=0.045). The incidence rates of nausea and vomiting as well as diarrhea in Endostatin group were prominently lower than those in Cisplatin group (p=0.039, p=0.048). According to the follow-up results, the median time to the progression of pleural effusion in Endostatin group was markedly longer than that in Cisplatin group (p=0.008).
Compared with the thoracic hyperthermic perfusion with cisplatin alone, the thoracic hyperthermic perfusion with recombinant human endostatin plus nedaplatin showed dramatically potential efficacy, decrease of the incidence rate of adverse reactions in the digestive system, improvement of quality of life of patients, and prolongation of progression of pleural effusion.
探讨重组人血管内皮抑制素联合奈达铂胸腔热灌注治疗晚期非小细胞肺癌（NSCLC）胸腔积液的疗效和安全性。
回顾性分析 122 例晚期 NSCLC 胸腔积液患者的临床资料，其中 61 例采用重组人血管内皮抑制素联合奈达铂胸腔热灌注（恩度组），61 例采用顺铂胸腔热灌注（顺铂组）。比较两组患者近期疗效、治疗前后胸腔积液及血清免疫指标变化、生活质量及不良反应发生率，随访并记录患者胸腔积液进展情况。
治疗后，恩度组患者的总缓解率明显高于顺铂组（p=0.030）。治疗后 2 周，两组患者丙氨酸氨基转移酶（ALT）水平明显升高，癌胚抗原（CEA）水平明显下降，恩度组患者 ALT 和 CEA 水平明显低于顺铂组（p=0.007，p=0.003）。治疗后，两组患者卡氏功能状态评分（KPS）均明显提高，恩度组 KPS 评分明显高于顺铂组（p=0.045）。恩度组恶心呕吐和腹泻的发生率明显低于顺铂组（p=0.039，p=0.048）。根据随访结果，恩度组胸腔积液进展的中位时间明显长于顺铂组（p=0.008）。
与单纯顺铂胸腔热灌注相比，重组人血管内皮抑制素联合奈达铂胸腔热灌注具有显著的疗效，降低了消化系统不良反应的发生率，改善了患者的生活质量，延长了胸腔积液的进展时间。
