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目的探讨沙利度胺联合白细胞介素2(IL-2)治疗肺癌合并恶性胸腔积液(MPE)的安全性及临床疗效。方法选取2013年3月至2014年3月间收治的60例肺癌合并MPE患者,按照随机数表法分为试验组和对照组,每组各30例。试验组患者采取沙利度胺联合胸腔引流加IL-2治疗,对照组患者采取胸腔引流加IL-2治疗。比较两组患者近期疗效、治疗前后血管内皮生长因子(VEGF)水平及不良反应。结果治疗结束后,试验组患者有效率(70.0%)明显高于对照组(50.0%,P<0.05)。试验组病情控制率(83.3%)明显高于对照组(56.7%,P<0.05)。两组患者治疗后血清VEGF水平均较治疗前下降(均P<0.05),且试验组患者下降程度显著大于对照组(P<0.05)。试验组患者咯血、消瘦的发生率显著低于对照组(均P<0.05)。结论沙利度胺联合IL-2治疗肺癌合并MPE时,能显著降低血清VEGF,从而抑制肿瘤的生长,提高治疗的有效率,并能减少治疗过程中咯血、消瘦等不良反应的发生,值得临床推广。
Objective To investigate the safety and clinical efficacy of thalidomide combined with interleukin-2 (IL-2) in the treatment of lung cancer complicated with malignant pleural effusion (MPE). Methods Sixty lung cancer patients with MPE who were admitted to our hospital from March 2013 to March 2014 were divided into experimental group and control group according to random number table method, with 30 cases in each group. Patients in the test group were treated with thalidomide combined with thoracic drainage plus IL-2, while patients in the control group were treated with pleural drainage plus IL-2. The short-term curative effect, the level of vascular endothelial growth factor (VEGF) and the adverse reactions before and after treatment were compared between the two groups. Results After the treatment, the effective rate of the experimental group (70.0%) was significantly higher than that of the control group (50.0%, P <0.05). Test group disease control rate (83.3%) was significantly higher than the control group (56.7%, P <0.05). Serum VEGF levels in both groups were significantly lower than those before treatment (all P <0.05), and the decrease in the experimental group was significantly greater than that in the control group (P <0.05). The incidence of hemoptysis and weight loss in the test group was significantly lower than that in the control group (all P <0.05). Conclusions Thalidomide combined with IL-2 in the treatment of lung cancer combined with MPE can significantly reduce serum VEGF, thereby inhibiting the growth of the tumor, increasing the effective rate of treatment, and reducing the occurrence of hemoptysis, weight loss and other adverse reactions in the course of treatment. Promotion.