【摘要】 目的探讨口服阿帕替尼或培美曲塞静脉化疗联合顺铂胸腔灌注对肺腺癌并发胸腔积液患者的有效性和安全性。方法选取2018年1月—2019年12月黑龙江省医院收治的肺腺癌患者60例为研究对象,将患者随机分为阿帕替尼组和培美曲塞组,每组30例。培美曲塞组患者接受培美曲塞静脉化疗联合顺铂胸腔灌注治疗,阿帕替尼组患者接受口服阿帕尼替联合顺铂胸腔灌注治疗。比较两组患者胸腔积液总有效率、中位无进展生存期(PFS)、生存质量(QoL)、毒副作用发生率。结果阿帕替尼组胸腔积液总有效率高于培美曲塞组(χ~2=5.455,P=0.020)。阿帕替尼组患者中位PFS为4.94个月,培美曲塞组患者中位PFS为4.86个月,两组比较差异无统计学意义(χ~2=0.009,P=0.925)。阿帕替尼组QoL有效率高于培美曲塞组(χ~2=4.800,P=0.028)。治疗期间,阿帕替尼组胃肠道反应(消化不良、呕吐、胃炎)、白细胞计数减少、血小板计数减少、乏力发生率低于培美曲塞组(P<0.05);阿帕替尼组高血压发生率高于培美曲塞组(P<0.05),但无Ⅳ级毒副作用,常规降压药物可使血压迅速降至正常。结论阿帕替尼联合顺铂胸腔灌注相比培美曲塞治疗肺腺癌并发胸腔积液疗效更佳,安全性更高。更多还原

【Abstract】 Objective To investigate the efficacy and safety of oral apatinib or intravenous chemotherapy with pemetrexed combined with cisplatin intrapleural perfusion for patients with lung adenocarcinoma complicated with malignant pleural effusion(MPE). Methods 60 patients with lung adenocarcinoma complicated with MPE in Heilongjiang Province Hospital from January 2018 to December 2019 were selected as the research objects, and they were divided into apatinib group and pemetrexed group according to the random number table method, 30 cases in each group. The patients in pemetrexed group were treated with intravenous chemotherapy with pemetrexed combined with cisplatin intrapleural perfusion, while the patients in apatinib group were treated with oral apatinib combined with cisplatin intrapleural perfusion. The total effective rate, median PFS, quality of life(QoL)and incidence of side effects were compared between the two groups. Results The total effective rate of pleural effusion in apatinib group was higher than that in pemetrexed group(χ~2=5.455, P=0.020). The median PFS in apatinib group was 4.94 months and in pemetrexed group was 4.86 months. There was no significant difference in median PFS between the two groups(χ~2=0.009, P=0.925). The effective rate of QoL in apatinib group was higher than that in pemetrexed group(χ~2=4.800, P=0.028). During treatment, the incidence of gastrointestinal reactions(dyspepsia, vomiting, gastritis), reduction in WBC and PLT, and fatigue in apatinib group were lower than those in pemetrexed group(P<0.05), the incidence of hypertension in apatinib group was higher than that in pemetrexed group(P<0.05), respectively. However, there were no grade Ⅳ side effects. Conventional antihypertensive drugs could rapidly reduce blood pressure to normal. Conclusion Compared with pemetrexed, the efficacy of apatinib combined with cisplatin intrapleural perfusion in the treatment of patients with lung adenocarcinoma complicated with pleural effusion is better, the safely is higher.更多还原