不同剂量rmh TNF治疗晚期肿瘤恶性胸腔积液患者的疗效观察
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摘要
目的观察不同剂量重组改构人肿瘤坏死因子(rmh TNF)治疗晚期肿瘤恶性胸腔积液患者的临床效果。方法选取医院肿瘤科收治的晚期肿瘤恶性胸腔积液患者60例,随机分为观察组和对照组,每组30例。对照组给予200万IU、观察组给予300万IU rmh TNF胸腔灌注治疗,比较2组临床疗效、生活质量改善情况、不良反应发生情况。结果观察组近期总有效率为90. 00%,高于对照组的66. 67%(P <0. 05);治疗结束1个月后,2组精神好转、食欲增加、体力增加、体质量增加方面比较差异无统计学意义(P> 0. 05);在睡眠改善、KPS评分提高方面比较,2组差异有统计学意义(P <0. 05); 2组不良反应发生情况比较差异无统计学意义(P> 0. 05)。结论 300万IU rmh TNF胸腔灌注治疗晚期肿瘤恶性胸腔积液的近期疗效优于200万IU,可改善患者的生活质量,而未增加药物的不良反应。
Objective To observe the clinical effect of different doses of rmh TNF in the treatment of malignant pleural effusion of advanced stage. Methods Sixty patients with advanced malignant pleural effusion were randomly divided into observation group and control group,30 cases in each group. The control group received 2 × 106 IU rmh TNF chest perfusion,while the observation group received 3 × 106 IU. The therapeutic effects,improvement of quality of life and incidence of adverse reactions were compared between the 2 groups. Results The total effective rate in the observation group was 90. 00%,which was higher than 66. 67% in the control group( P < 0. 05). One month after treatment,there was no significant difference in mental,appetite,physical strength and body mass between the two groups( P > 0. 05). There was a significant difference in the improvement of sleep and the improvement of KPS score between the 2 groups( P < 0. 05). There was no significant difference in the incidence of adverse reactions between the 2 groups( P > 0. 05). Conclusion Using rmh TNF to treat advanced malignant pleural effusion,the short-term efficacy of 3 × 106 IU dosage is better than that of 2 × 106 IU dosage,which can improve the quality of life of patients without increasing the risk of adverse reactions.
Objective To observe the clinical effect of different doses of rmh TNF in the treatment of malignant pleural effusion of advanced stage. Methods Sixty patients with advanced malignant pleural effusion were randomly divided into observation group and control group,30 cases in each group. The control group received 2 × 106 IU rmh TNF chest perfusion,while the observation group received 3 × 106 IU. The therapeutic effects,improvement of quality of life and incidence of adverse reactions were compared between the 2 groups. Results The total effective rate in the observation group was 90. 00%,which was higher than 66. 67% in the control group( P < 0. 05). One month after treatment,there was no significant difference in mental,appetite,physical strength and body mass between the two groups( P > 0. 05). There was a significant difference in the improvement of sleep and the improvement of KPS score between the 2 groups( P < 0. 05). There was no significant difference in the incidence of adverse reactions between the 2 groups( P > 0. 05). Conclusion Using rmh TNF to treat advanced malignant pleural effusion,the short-term efficacy of 3 × 106 IU dosage is better than that of 2 × 106 IU dosage,which can improve the quality of life of patients without increasing the risk of adverse reactions.
引文
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[11]邓见青,苏清清,张少伟,等.贝伐单抗联合化疗药物胸腔灌注治疗肺癌合并恶性胸腔积液的Meta分析[J].中华胸部外科电子杂志,2017,4(2):112-119. DOI:10. 3877/cma. j. issn. 2095-8773. 2017. 02. 009.
[12]陆向东,张汀荣.重组人血管内皮抑制素联合顺铂胸腔内灌注治疗晚期非小细胞肺癌恶性胸腔积液的疗效[J].江苏医药,2016,43(14):1023-1025. DOI:10. 19460/j. cnki. 0253-3685.2017. 14. 013.
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[15] Neragi-Miandoab S. Mlignant pleural effusion,current and evolving approaches for its diagnosis and management[J]. Lung Cancer,2006,54(1):1-9.
[16]李晓芳,王海雄,裴毅.重组改构人肿瘤坏死因子与顺铂治疗恶性胸/腹腔积液的临床对比观察[J].临床医药实践,2015,24(6):406-408.
[17] Deroose JP,Eggermont AMM,van Geel AN,et al. 20 years experience of TNF-based isolated limb perfusion for in-transit melanoma metastases:TNF dose matters[J]. Ann Surg Oncol,2012,19(2):627-635.
[18]秦叔逵,刘秀峰,等.注射用重组改构人肿瘤坏死因子治疗国人恶性胸、腹腔积液的前瞻性多中心临床研究[J].临床肿瘤学杂志. 2016,21(7):577-584.
[19]上海唯科生物制药有限公司.注射用重组改构人肿瘤坏死因子说明书[EB/OL].[2016-03-11]. http://yao. 360jk. com/71705/sms/.
[20]米丽丽,王伟,王瑞,等.重组改构人肿瘤坏死因子联合TC方案术后辅助治疗非小细胞肺癌的效果[J].实用医学杂志,2013,29(18):3051-3053. DOI:10. 3969/j. issn. 1006-5725. 2013. 18.045.
[2] Simpson G,Judge DJ. Management of malignant pleural effusion[J].Respirology,2015,20(1):169.
[3]康艳霞,闵婕,附舰,等.重组人血管内皮抑素联合顺铂胸腔聂循环热灌注治疗肺癌合并恶性胸腔积液的疗效观察[J].现代肿瘤医学,2013,21(11):2485-2487. DOI:10. 3969/j. issn. 1672-4992.2013. 11. 029.
[4]王宗林,戴天阳,詹福生,等.钾通道在重组改构人肿瘤坏死因子抑制肺癌细胞增殖中的作用[J].中国肺癌杂志,2006,9(5):399-404.
[5]金阳,熊先智,陶晓海,等.重组改构人肿瘤坏死因子对小细胞肺癌化疗的干预[J].中国医院药学杂志,2006,26(3):270-272.DOI:10. 3321/j. issn:1001-5213. 2006. 03. 010.
[6]魏东,苏晓姝,刘焕义,等.重组改构人肿瘤坏死因子胸腔内灌注治疗肺癌性胸腔积液[J].中国肺癌杂志,2005,8(5):474.
[7]孙燕,哈献文.临床肿瘤诊疗关键[M].南宁:广西科学技术出版社,1999:633-643.
[8]施焕中,张予辉.恶性胸腔积液诊断与治疗专家共识解读[J].中华医学信息导报,2014,29(9):18. DOI:10. 3760/j. issn. 1000-8039. 2014. 09. 011.
[9]陈万青,张思维,邹小农.中国肺癌发病死亡的估计和流行趋势研究[J].中国肺癌杂志,2010,13(5):488-493. DOI:10. 3779/j.issn. 1009-3419. 2010. 05. 020.
[10]杨婉玲,付秀华,顾岩.恶性胸腔积液的治疗进展[J].医学综述,2017,23(5),971-980. DOI:10. 3969/j. issn. 1006-2084. 2017.05. 030.
[11]邓见青,苏清清,张少伟,等.贝伐单抗联合化疗药物胸腔灌注治疗肺癌合并恶性胸腔积液的Meta分析[J].中华胸部外科电子杂志,2017,4(2):112-119. DOI:10. 3877/cma. j. issn. 2095-8773. 2017. 02. 009.
[12]陆向东,张汀荣.重组人血管内皮抑制素联合顺铂胸腔内灌注治疗晚期非小细胞肺癌恶性胸腔积液的疗效[J].江苏医药,2016,43(14):1023-1025. DOI:10. 19460/j. cnki. 0253-3685.2017. 14. 013.
[13]汪睿,史清明. 76例恶性胸腔积液局部治疗与联合化疗的疗效分析[J].安徽医学,2012,33(9):1171-1172. DOI:10. 3969/j.issn. 1000-0399. 2012. 09. 024.
[14]严文跃,钱晓萍,刘宝瑞.恶性胸腔积液的治疗进展[J].现代肿瘤医学,2009,17(7):1393-1396. DOI:10. 3969/j. issn. 1672-4992. 2009. 07. 077.
[15] Neragi-Miandoab S. Mlignant pleural effusion,current and evolving approaches for its diagnosis and management[J]. Lung Cancer,2006,54(1):1-9.
[16]李晓芳,王海雄,裴毅.重组改构人肿瘤坏死因子与顺铂治疗恶性胸/腹腔积液的临床对比观察[J].临床医药实践,2015,24(6):406-408.
[17] Deroose JP,Eggermont AMM,van Geel AN,et al. 20 years experience of TNF-based isolated limb perfusion for in-transit melanoma metastases:TNF dose matters[J]. Ann Surg Oncol,2012,19(2):627-635.
[18]秦叔逵,刘秀峰,等.注射用重组改构人肿瘤坏死因子治疗国人恶性胸、腹腔积液的前瞻性多中心临床研究[J].临床肿瘤学杂志. 2016,21(7):577-584.
[19]上海唯科生物制药有限公司.注射用重组改构人肿瘤坏死因子说明书[EB/OL].[2016-03-11]. http://yao. 360jk. com/71705/sms/.
[20]米丽丽,王伟,王瑞,等.重组改构人肿瘤坏死因子联合TC方案术后辅助治疗非小细胞肺癌的效果[J].实用医学杂志,2013,29(18):3051-3053. DOI:10. 3969/j. issn. 1006-5725. 2013. 18.045.