| Objective: The purpose of this study is to retrospectively analyze the effectiveness of the recombinant human endostatin(Endostar,rh-ES)combined with Cisplatin in the treatment of MPE with advanced lung cancer,symptom improvement,adverse reactions and overall survival of the patients.Methods: A total of 33 patients with Multiline therapy for advanced lung cancer with MPE admitted to Wuhan Central Hospital from January 2015 to May 2017 were collected and divided into two groups: the rh-ES combined Cisplatin group(14 cases)and Cisplatin alone group(19 cases).The KPS scores were all greater than 60 points,and no chemotherapy-related contraindications were confirmed after examination.Before treatment,thoracentesis was performed to collect pleural effusions for biochemical,cytological examination,and tumor marker levels in pleural effusion.Malignant cells and abnormal tumor markers found in pleural effusions were confirmed as MPE.The pleural effusion was drained as much as possible within 1-3 days.Pretreatment with antiemetic and acupuncture was given before chemotherapy.In the combined perfusion group,the rh-Es 45 mg was injected through the pleural catheter,followed by 40 mg of Cisplatin.The saline was diluted and injected into the chest sequentially.In the monotherapy group,40 mg of Cisplatin was diluted with physiological saline and then perfused through a catheter such as the thoracic cavity.The patients were then instructed to change position one time every half hour for two hours so that the concentration of the drug in the thoracic cavity was evenly distributed.During the treatment,pay attention to whether the patients had any adverse reactions.On the second day after treatment,liver and kidney function,blood routine,electrocardiogram,and other examinations were reviewed.After 1 month,the efficacy was evaluated by assessing the amount of pleural effusion by reviewing the maximum depth of pleural effusion before and after the examination of chest watercolors.Results: The comparison of the two groups of treatment results showed that the efficacy of the combination of Endostar and Cisplatin was significantly superior to that of Cisplatin alone,with a statistically significant difference(X2=4.01,P=0.045<0.05).The quality of life in both groups was based on KPS scores before and after treatment: 11 cases in the combined group were improved,2 stable,and 1 decreased.In the monotherapy group,12 cases improved,5 cases were stable,and 2 cases decreased.The improvement rates were 78.6% and 63.2% respectively.Adverse reactions analysis and evaluation showed that: the degree of adverse reactions was small,and most of the performance was mild.A small number of grade III and IV adverse events occurred,and there was no significant difference between the two groups.None of the 33 patients who received treatment withdrew treatment because they could not tolerate toxic effects.The median overall survival time(OS)was 5.2 months and 3.9 months,respectively,with statistical differences(t=2.13,P=0.041<0.05).Conclusion: Compared with Cisplatin alone,intrapleural Endostar combined with Cisplatin infusion therapy has a better therapeutic effect on MPE.Not only does it improve the quality of life of MPE patients,but the use of Endostar's participation does not have an additional impact.Future studies should include strictly randomized controlled trials and recruit more patients for the extensive clinical use of Endostar and Cisplatin combination for MPE. |
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