Department of Clinical Trial, The Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China.
Postgraduate training base Alliance of Wenzhou Medical University (Zhejiang Cancer Hospital), Hangzhou, China.
Cancer Med. 2023 Sep;12(17):18211-18218. doi: 10.1002/cam4.6404. Epub 2023 Aug 2.
Malignant pericardial effusion (MPE) is a serious complication of cancer that can be potentially deadly. It usually occurs in advanced or terminal stages of the disease, and as a result, patients with MPE often have a poor prognosis. There is a limited amount of research available that directly compares the effectiveness and safety of intrapericardial drug administration following pericardial drainage versus catheter drainage alone in non-small cell lung cancer (NSCLC) patients who have MPE.
We retrospectively included 86 patients with NSCLC with MPE at Zhejiang Cancer Hospital. Survival and recurrence estimates were determined with the Kaplan-Meier method.
We divided the 86 patients with NSCLC into two groups: a pericardial drainage group (34 out of 86, 39.5%) and an intrapericardial administration group (52 out of 86, 60.5%). The response rates were 70.6% and 76.9% (p = 0.510), respectively. The median OS was 132.0 and 234.0 days (p = 0.579), respectively. The median time to recurrent drainage was 43.0 and 104.0 days (p = 0.170), respectively. The incidence of adverse events (AEs) was 44.1% and 61.5% (p = 0.113), respectively. The most frequent AEs were pain (27.9%) and fever (24.4%). Additionally, two patients in the intrapericardial administration group died of cardiac arrest.
Compared with catheter drainage alone, intrapericardial medication infusion during catheter drainage did not have significantly different effects. AEs require close monitoring and management.
恶性心包积液(MPE)是癌症的严重并发症,可能致命。它通常发生在疾病的晚期或终末期,因此,患有 MPE 的患者预后通常较差。目前,直接比较心包引流后心包内药物给药与单纯导管引流在非小细胞肺癌(NSCLC)伴 MPE 患者中的疗效和安全性的研究有限。
我们回顾性纳入了浙江省肿瘤医院 86 例 NSCLC 伴 MPE 患者。采用 Kaplan-Meier 法确定生存和复发估计值。
我们将 86 例 NSCLC 患者分为两组:心包引流组(86 例中的 34 例,39.5%)和心包内给药组(86 例中的 52 例,60.5%)。有效率分别为 70.6%和 76.9%(p=0.510)。中位 OS 分别为 132.0 和 234.0 天(p=0.579)。中位再引流时间分别为 43.0 和 104.0 天(p=0.170)。不良事件(AE)发生率分别为 44.1%和 61.5%(p=0.113)。最常见的 AE 是疼痛(27.9%)和发热(24.4%)。此外,心包内给药组有 2 例患者死于心脏骤停。
与单纯导管引流相比,导管引流期间心包内药物灌注的效果没有明显差异。AE 需要密切监测和管理。