Clinical observation of intrapleural hyperthermic perfusion chemotherapy for patients with malignant pleural effusion caused by lung cancer / 国际肿瘤学杂志

ABSTRACT

Objective To observe the efficacy and adverse reaction of intrapleural hyperthermic perfusion and intrapleural chemotherapy for patients with malignant pleural effusion (MPE) caused by lung cancer.Methods A total of 103 patients with MPE caused by lung cancer were assigned into one of two groupsintrapleural hyperthermic perfusion group (n =65) and intrapleural chemotherapy group (n =38).The disease control rate,MPE progress free survival,the relationship between vascular endothelial growth factor (VEGF) concentration in pleural effusion and curative effect and adverse reactions were observed.Results The overall disease control rate in intrapleural hyperthermic perfusion group and intrapleural chemotherapy group was 81.5％ and 52.6％ respectively,with a significant difference (x2 =9.834,P =0.002).The median MPE progress free survival of the two groups was 3.10 and 2.15 months respectively,with a significant difference (x2 =10.512,P =0.001).A significant difference of the median MPE progress free survival was observed in low VEGF concentration subgroup between intrapleural hyperthermic perfusion and intrapleural chemotherapy (3.34 months vs.2.20 months;x2 =9.409,P =0.002),but no difference was observed in high VEGF expression subgroup (2.85 months vs.2.10 months;x2 =2.429,P =0.119).The main adverse reactions included gastrointestinal adverse reaction,fatigue and hematotoxicity.Fatigue occurred in intrapleural hyperthermic perfusion group more commonly compared with intrapleural chemotherapy group (67.7％ vs.13.2％;x2 =28.595,P ＜ 0.001).Conclusion Compared with intrapleural chemotherapy,intrapleural hyperthermic perfusion can better improve disease control rate and MPE progress free survival in MPE patients caused by lung cancer,and it's adverse reactions are tolerated easily.The MPE progress free survival prolonging is observed especially in VEGF low expression subgroup.VEGF level in pleural effusions maybe could predict efficacy of intrapleural hyperthermic perfusion.