白介素-2、顺铂及两药联合局部治疗恶性胸腔积液的汇集分析
A pooled analysis of intrapleural perfusion with interleukin-2 and /or cisplatin for malignant pleural effusion
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摘要: 目的:探讨白介素-2(IL-2)、顺铂(DDP)或两药联合在胸腔局部使用治疗恶性胸腔积液(MPE)的临床运用价值。方法:对1993～2009年文献中关于MPE治疗3 778例患者疗效、不良反应的数据进行汇集分析,分为IL-2组1 499例,DDP组708例,IL-2+DDP组1 571例。再以随机研究,非合并其他治疗为筛选标准筛选出临床随机对照试验数据,IL-2组335例,DDP组513例,IL-2+DDP组460例。结果:IL-2组总有效率80.05%及IL-2+DDP组81.41%均高于DDP组58.05%;3组总体不良反应中发热、骨髓毒性、胸痛、消化道反应、肝功能损伤及肾功能损伤发生率差异均有统计学意义(P0.01)。IL-2+DDP组随机数据有效率84.13%、IL-2组77.01%均高于DDP组58.67%(P0.05);3组随机研究患者发热、骨髓毒性、胸痛、消化道反应、肝功能损伤及肾功能损伤发生率差异均有统计学意义(P0.01)。结论:IL-2对MPE有明显的疗效,晚期恶性肿瘤伴有MPE的患者,IL-2单药治疗在保证较好疗效的同时,具有相对较好的耐受性,可显著提高患者生活质量。Abstract: Objective: To evaluate the clinical value of intrapleural perfusion of interleukin-2(IL-2),cisplatin(DDP) or the combined therapy for malignant pleural effusion(MPE) patient.Methods: A pooled analysis was taken which based on the data of efficacy and toxicity of treatments in 3 778 MPE patients from 1993 to 2009,1 499 patients were treated with IL-2 alone,708 patients were treated with cisplatin alone,and 1 571 patients were treated by the combined therapy.The clinic randomized control trail data were screened according to the standard of randomized study without other therapies.Three hundred thirty and five patients were in the IL-2 group,513 patients were in the DDP group and 460 patients were in the combined therapy group.Results: In non-randomized study,the effective rate in IL-2 group was 80.05%,the combined therapy group was 81.41%,which were higher than in DDP group with 58.05%.The adverse reaction rates including heating,bone marrow toxicity,chest pain,gastrointestinal reaction,hepatotoxic and nephrotoxicity had significant differences(P 0.01).In randomized study,the effective rate in IL-2 group was 77.01% and the combined therapy group was 84.13%,which were higher than in DDP group with 58.67%(P 0.05).The adverse reaction rates including heating,bone marrow toxicity,chest pain,gastrointestinal reaction,hepatotoxic and nephrotoxicity had significant differences(P 0.01) among 3 groups in randomized study.Conclusions: It has a good effective therapy with IL-2 alone and well tolerated for MPE patients,which could improve the quality of life.
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Key words:
- malignant pleural effusion /
- interleukin-2 /
- cisplatin
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