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不同剂量rmhTNF治疗晚期肿瘤恶性心包积液的疗效观察

Therapeutic-effect of Different Dosage of rmhTNF in Curing Malignancy Pericardial Effusion of Advanced Tumor

  • 摘要: 目的 探讨重组改构人肿瘤坏死因子(rmhTNF)在治疗恶性心包积液中的疗效、不良反应及对生活质量的影响;并比较两种不同剂量rmhTNF的疗效差异。方法64例肿瘤患者采用计算机随机法分为A、B两组,分别于心包腔内置管灌注rmhTNF 1500 万IU(大剂量A组)、rmhTNF 500 万IU(常规剂量B组),连续治疗4次。治疗结束1月后按WHO标准评价疗效和不良反应及对生活质量的影响。结果A组总有效率90.6%,完全缓解率达到62.5%;B组总有效率达到56.2%,完全缓解率达到37.5%,两组比较差异有统计学意义(P<0.05)。不良反应两组相似,差异无统计学意义(P>0.05)。两组患者生活质量都有不同程度改善,在精神好转、食欲增加、体力增加、体重增加上两组比较差异无统计学意义(P>0.05);在睡眠、KPS评分两组比较有明显差异,A组改善更明显(P<0.05)。结论rmhTNF治疗癌性心包积液疗效好,不良反应小,可以改善患者生活质量。大剂量A组与常规剂量B组比较,完全缓解率更高,疗效更显著,而不良反应差别不明显。

     

    Abstract: Objective To discuss rmhTNF's(recombination construct human tumor necrosis factor) effects in curing malignancy pericardial effusion in three aspects,including therapeutic effect,toxic reaction and influence on life quality.And compare the difference of two kinds of dosage-form of rmhTNF in the three aspects.MethodSixty-four cases were divided into two groups randomly: A group (large dose group) accepted 1500×103IU rmhTNF,and B group (normal dose group) accepted 500×103IU rmhTNF injection.Both groups were injected for 4 times.One month later after the last injection,the therapeutic effect,toxic reaction and quality of life were evaluated according to the WHO standard. Results The total effective rate of the two groups was 90.6% vs.56.2% (A vs.B),CR was 62.5% vs.37.5% (A vs.B).The therapeutic effect of large dose group was higher statistically than that of normal dose group,but they didn't have obvious difference in toxic reaction.All the cases' life quality were improved,and the two groups had significant deviation in sleeping quality and KPS score,but not in increasing appetite,weight gain,spirit recovering,or physical strength. Conclusion rmhTNF not only had better therapeutic effect and less toxic reaction,but also could improve life quality in curing malignancy pericardial effusion.Especially,large dose rmhTNF had a higher CR,more notable curative effect,and less adverse reaction than that of moral dose.

     

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