Clinical Observation Of Combination Systemic Chemotherapy With Chest Tube Drainage And Intrapleural Administration Of Biological Agents In Patients With Malignant Pleural Effusions From Lung Cancer

Objectives:To observe the efficacy and toxicity of combination systemic chemothe-rapy with chest tube drainage and intrapleural administration of biological agents in patients with malignant pleural effusions(MPE) from lung cancer.Methods:We retrospectively analyzed the clinical data of22patients with malignant pleural effusions from lung cancer. All patient had cytological or histological proof of MPE.these patiants are devided into two groupes. Group A:11patients accepted chest tube drainage and intrapleural administration of biological agents; Group B:11patients accepted combination systemic chemotherapy with chest tube drainage and intrapleural administration of biological agents.11patients in group A received injections of chest tube drainage according to the conventional operation,then treated by intrapleural injection of mannatide (20～40mg,2～3tims per week)or streptococcus(2～5KE,2～3tims per week).Group B combined additional systemic chemotherapy. After the treatment, the efficacy were evaluated according to the response criteria of World Health Organization (WHO).We observe the Objective Response Rate(ORR),Disease Control Rate (DCR) and Clinical Benefit Rate(CBR).The toxicity were evaluated according to the toxicity criteria of WHO.Results:In group A, ORR (Complete Response, CR+Partial Response, PR) was27.3%(3/11), DCR (CR+PR+Stable Disease, SD) was36.4%(4/11), CBR was27.4%(3/11).In group B,ORR (CR+PR) was81.8%(9/11), DCR (CR+PR+SD) was90.9%(4/11), CBR was81.8%(9/11).The ORR, DCR and CBR of group A were higher than group B,the differences were statistically signifinant(P<0.05). There was no treatment-related death.The main toxicity of the two groups were bone marrow suppression,liver dysfunction, gas-trointestinal reactions,fever and Chest pain. The drug toxicity incidence of group A was45.5%and group B54.5%. There were no signifinant differences of drug toxicity between group A and group B (P>0.05).Conclusions:The ORR, DCR and CBR were high in patients with malignant pleural effusions(MPE) from lung cancer,who received combination systemic chemotherapy with chest tube drainage and intrapleural administration of biological agents. The efficacy of is more effective than chest tube drainage and intrapleural administration of biological agents,and toxicity can be tolerated. Therefore, further trials are needed.