The Clinical Observation Of Brucea Javanica Oil Injection And Cisplatin Infused In Thorax In Treatment Of Malignant Pleural Effusion Caused By Lung Cancer

Objective The increased incidence of lung cancer has exceedingly harmed human health. Our latest cancer statistics show that male lung cancer incidence in our country topped the list,and in the second place of female. In addition, the lung cancer death rate is already the highest of malignant tumor. The occurrence and development of lung cancer is a complex process with many factors. The early diagnosis is difficult of lung cancer, for most patients with no obvious clinical symptoms. While most of the patients are diagnosed they already belongs to the disease advanced. Lung cancer progressed rapidly, and various complications emerge, in varying degrees to reduce a patient’s quality of life, shorten the patient’s survival. More than half are likely to occur in patients with malignant pleural effusion of lung cancer complications. Once malignant pleural effusion happens, effusion is often more common to moderate amounts and large amounts of fluid. Massive pleural effusion on pulmonary dilation caused by mechanical compression leads to effects on heart and lung function, prone to complications such as atelectasis. Due to heart and lung function is affected, often occur in patients with more severe symptoms. Main aim of treatment is to reduce the malignant pleural effusion in patients with chest tightness, shortness of breath, chest pain and coughing and other symptoms, and preventing the recurrence of pleural effusion. While in treatment of malignant pleural effusion has more treatment options, but which recurrent features in recent years that the effect is still not satisfactory. Combined with chemotherapeutic drugs and traditional Chinese medicine injection to treat pleural infusion, many researchers believe that chemotherapeutic drugs and traditional Chinese medicine injections work together, result in significantly improved immune function and quality of life of patients with, and effectively reduce the chemotherapeutic drugs in the treatment of adverse reactions. This clinical trials of the selection of brucea javanica oil injection combined with pleural infusion of cisplatin injection therapy, confirmed the combined effective rate significantly higher than cisplatin monotherapy group.Methods This clinical trials select 60 cases non-small cell lung cancer patients were confirmed by histopathology and cytology with malignant pleural effusion from January 2013 to January 2015 in inpatient randomly divided into two groups, each group of 30 patients. The 60 patients are confirmed by radiographic pleural effusion in moderate amounts and above. Don’t do any treatment to malignant pleural effusion measures. The selected patients with liver and kidney function, blood count, urinalysis and electrocardiogram are normal. KPS score >60 points. Expected survival time has to not less than 3 months. In accordance with random number tables into observation group and control group, 30 patients in each group. Enrolled patients with b-type ultrasonic positioning then closed thoracic drainage, indwelling central venous catheters, detailed record daily volume of pleural effusion. Review of chest ultrasound, confirm drain pleural effusion or pleural effusion drainage per day when <50ml began thoracic perfusion. Observation group: a total of 30 cases. Thoracic drainage tube injection of brucea javanica oil injection 60~90ml+ cisplatin 20~30mg/m2+2% 5mg injection of lidocaine + dexamethasone injection 5ml and then 20 ml saline rinse catheter closed conduits. injected every week, injection of 3 times in a row. Control group: a total of 30 cases. Thoracic drainage tube injection of cisplatin 20 ~30mg/m2+2% 5mg injection of lidocaine + dexamethasone injection 5ml and then 20 ml saline rinse catheter closed conduits. injected every week, injection of 3 times in a row. Patients with pleural infusion treatment for every 20 min in supine, left lateral decubitus and head high low supine posture change positions again, a total of 2 hours and clipping 48 h drainage tubes, to make the drug and pleura full access. Intrathoracic drenching 1 days ago and after drenching a week, review blood routine examination and observe the drainage of pleural effusion, effusion color variation and a chest pain, fever, cough, nausea and vomiting and bone marrow depression and other adverse reactions. At 4 weeks after the end of treatment were observed after treatment efficacy evaluation, evaluation of the quality of life and toxicity evalua of the clinical observation of brucea javanica oil injection and cisplatin infused in thorax in treatment of malignant pleural effusion caused by lung cancer. All datas use SPSS19.0 software to statistical analysis.Results1 objective response rate: Complete remission in 15 cases in the observation group and partial remission in 11 cases, stability in 3 cases, progress 1.control group complete remission in 8 cases, partial remission 10 cases, stable in 8 cases, progress in 4 cases.The objective response rate of the observation group and the control group, are 86.7% and 60% respectively, observation group was significantly higher than the control group, the difference between the two groups is statistically significant(P<0.05).2 centers for disease control rate:The disease control rates of treatment and control groups are 96.6% and 86.6%, And the difference between the two groups is statistically significant(P<0.05).3 quality of life: The observation group and the control group continued to improve the quality of life patients ≥ 21 days are 90.0% and 66.7%. the observation group is significantly better than the control group, the difference between the two groups was statistically significant(P<0.05).4 toxicity: The observation group and the control group during the treatment period, and no obvious serious complications such as hemorrhage, pneumothorax, and no deaths. The major toxic reactions between the observation group and the control group are chest pain and fever, and rashes, nausea and vomiting, they are inⅠ~Ⅱ, no Ⅲ~Ⅳ of toxic reactions and resolved after by symptomatic treatment. 11 cases of chest pain in the observation group and 10 cases of fever, nausea and vomiting in 2 cases, 2 cases of a skin rash, leukopenia, 0; controls chest pain in 10 cases, 9 cases of fever and rash in 3, 2 case of nausea and vomiting, neutropenia in 3 case. And there is no statistically significant difference between the two groups(P>0.05). In addition, during the treatment, 3 cases occurred in the control group with encapsulated pleural effusion and 1 cases occurred in the observation group with encapsulated pleural effusion. Compared with the two group P=0.301>0.05,there is no statistically significant difference.Conclusions 1 Brucea javanica oil injection combined with chemotherapy in treatment of malignant pleural effusion caused by lung cancer effect, objective response rate is superior to cisplatin infused in thorax in observation groups as a single agent, and improve the quality of life, safety, toxicity and side effects.2 Brucea javanica oil injection possesses synergistic anticancer effect.