RESUMEN
Objective To evaluate the therapeutic effect and possible mechanism of intrapleural administra- tion of cisplatin bound to activated carbon particles for treating malignant pleura] effusions(MPE). Methods ①60 patients with MPE confirmed in the Third Hospital of Changzhou and the Second Hospital of Changzhou from 2004 to 2007 were randomly divided into treatment group (n=30)and control group(n=30). Chest catheters were inserted percutaneously into the pleural space to drain the effusions. Cisplatin mixed with activated carbon particles for the treatment group and only cisplatin for the control group were injected into pleural cavity. Whether above-mentioned treatment should be repeated was determined by ultrasonic B every week until up to four times. Curative effect and side-effect were compared between two groups a month later. ②20 cases, randomly selected from both groups respectively, underwent whole body and chest SPECT scan to image lymphatic system by means of 99Tcm-DX after effusions drainage but before intrapleural injection of drug. Cases whose imaging graphics were abnormal would undergo the above SPECT again 2 weeks after intrapleural injection of drug so as to find changes in imaging graphics. Results ① The overall response rate was significantly higher in treatment group than in control group(100% (30/30) vs 66.7% (20/30), χ2=12.00, P<0.01)and that intrapleural injection was needed only once in most cases. Gastrointestinal upset and leucoponia were less and milder in treatment group than in control group (16.7% (5/30) vs 30.0% (9/30) and 6.7% (2/30) vs 20.0% (6/30) respectively),but there was no statistical difference between the two groups(χ2=1.49 and 1.30,P>0.05). ②The rate of improvement in lymphatic imaging was significantly higher in treatment group than in control group (78.6% (11/14) vs 37.5% (6/16),P<0.05). Conclusion The treatment of malignant pleural effusions with intrapleural administration of cisplatin bound to activated carbon particles is extremely effective and safe, and can improve lymphatic drainage as well.