摘要
目的探讨手术联合术后循环胸腔热灌注化疗治疗肺癌合并胸膜转移的临床疗效及预后因素。方法回顾性分析我院2007年7月~2012年12月行手术联合循环胸腔热灌注化疗的42例肺癌合并胸膜转移患者的临床资料,总结其预后,并进行单因素生存分析和多因素分析。结果 42例手术联合术后循环胸腔热灌注化疗治疗肺癌合并胸膜转移患者的中位生存期为28个月,1、2、3年的累计生存率分别为94.7%、68.5%、28.2%。单因素分析显示年龄、肿瘤病理类型、肿瘤直径、手术方式与预后无关（P〉0.05）,而性别（χ2=5.773,P=0.016）、纵隔淋巴结状态（χ2=5.145,P=0.023）以及术前胸水情况（χ2=5.262,P=0.022）与术后生存相关。Cox预后多因素回归分析发现纵隔淋巴结情况（P=0.031）以及术前胸水情况（P=0.002）是影响预后的独立因素。结论应用手术联合循环胸腔热灌注化疗治疗肺癌合并胸膜转移安全有效。纵隔淋巴结情况以及术前胸水情况是影响预后的重要因素。
Objective To investigate the effects and clinical prognostic factors of resection and continuous intrapleural hyper-thermochemotherapy perfusion in the treatment of lung cancer with pleural metastasis. Methods The clinical data of 42 cases suffered lung cancer with pleural metastasis admitted from July 2007 to December 2012 were analyzed retrospectively. All cases were performed surgical intervention and postoperative continuous intrapleural hyper-thermochemotherapy perfusion. Results The median survival of all 42 patients was 28 months,and 1-,2- and 3-year accumulative survival rates was 94. 7%,68. 5% and 28. 2%,respectively. Univariate analysis revealed gender（ χ2= 5. 773,P = 0. 016）,mediastinal lymph nodal involvement（ χ2= 5. 145,P = 0. 023） and preoperative malignant pleural effusion（ χ2= 5. 262,P = 0. 022） were the related factors of postoperative survival,while age,pathological type of tumor,diameter of tumor and surgical procedure were not the correlation factor（ P〉0. 05）. Multivariate analysis showed that mediastinal lymph nodal involvement（ P = 0. 031） and preoperative malignant pleural effusion status（ P = 0. 002） were significant predictors for overall survival rate. Conclusions The combination therapy of the surgical procedure and postoperative continuous intrapleural hyper-thermochemotherapy perfusion may be a potentially curative treatment in selected patients of lung cancer with pleural dissemination. Patients with mediastinal nodal involvement and with malignant pleural effusion have significant worse overall survival rate.
出处
《中国现代手术学杂志》
2015年第4期241-245,共5页
Chinese Journal of Modern Operative Surgery
关键词
肺肿瘤
胸膜转移
胸腔积液
恶性
化学疗法
肿瘤
局部灌注
lung neoplasms
pleural metastasis
pleural effusion
malignant
chemotherapy
cancer
regional perfusion
