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目的:观察热灌注化疗联合贝伐珠单抗治疗消化道癌合并胸腔积液的临床疗效。方法:选择晚期消化道癌合并胸腔积液67例,随机分为观察组34例和对照组33例。对照组采用单纯胸腔内热灌注化疗,观察组在此基础上联合贝伐珠单抗治疗,每2周1次,连用2次。比较两组近期疗效、生活质量改善情况及不良反应发生情况。结果:观察组治疗有效率82.4%,显著高于对照组的72.7%(P<0.05);综合生活质量改善率79.4%,显著高于对照组的63.6%(P<0.05);5种功能状态(躯体、角色、情感、认知及社会功能)改善率均显著高于对照组(P<0.05);乏力、食欲减退、呼吸困难、胸闷胸痛及咳嗽等消化道癌相关症状改善率均显著高于对照组(P<0.05)。两组发热、白细胞减少、恶心呕吐、咯血发生率比较,差异均不显著(P>0.05)。经对症治疗后,白细胞减少、恶心呕吐及咯血均有所缓解,未发生转氨酶升高和肾功能损害。结论:热灌注化疗联合贝伐珠单抗治疗消化道癌合并胸腔积液,有效、安全,且有助于改善患者生活质量,延长其生存期。
Objective: To observe the clinical effect of thermal infusion chemotherapy combined with bevacizumab in the treatment of gastrointestinal cancer combined with pleural effusion. Methods: Sixty-seven patients with advanced gastrointestinal cancer and pleural effusion were randomly divided into observation group (34 cases) and control group (33 cases). The control group was treated with intrathoracic thermal perfusion chemotherapy only. The observation group was treated with bevacizumab once a week for 2 times. Compare the two groups of short-term efficacy, quality of life and adverse reactions. Results: The effective rate of observation group was 82.4%, which was significantly higher than that of control group (72.7%, P <0.05). The comprehensive quality of life improvement rate was 79.4%, significantly higher than that of control group (63.6%, P <0.05) (Body, character, emotion, cognition and social function) were significantly higher than those in the control group (P <0.05). The improvement rate of gastrointestinal cancer-related symptoms such as fatigue, loss of appetite, dyspnea, chest pain, chest pain and cough were all significantly higher In the control group (P <0.05). Two groups of fever, leukopenia, nausea and vomiting, hemoptysis incidence differences, the difference was not significant (P> 0.05). After symptomatic treatment, leukopenia, nausea and vomiting and hemoptysis were eased, elevated aminotransferases and renal dysfunction did not occur. Conclusion: The combination of hot perfusion chemotherapy and bevacizumab in the treatment of gastrointestinal cancer combined with pleural effusion is effective and safe, and it can help improve the quality of life and prolong the survival of patients.