Efficacy of pemetrexed and cisplatin combined with hyperthermic intrathoracic perfusion of bevacizumab in treatment of patients with non-small cell lung cancer and pleural effusion

Chen Jin-hong; Zhang Yan; Chen Guo-dong; Lu Xiao-min

doi:10.3969/j.issn.1672-8157.2025.02.012

Abstract：Objective To explore the efficacy of pemetrexed+cisplatin chemotherapy combined with thoracic hyperthermic perfusion of bevacizumab in treatment of advanced non-small cell lung cancer(NSCLC)with pleural effusion.Methods A total of 60 patients with NSCLC and pleural effusion treated in Hai'an People's Hospital from January 2023 to July 2024 were selected and divided into two groups.The patients in the control group were given pemetrexed+cisplatin chemotherapy,and those in the ob-servation group were additionally given thoracic hyperthermic perfusion of bevacizumab.The clinical efficacy,serum tumor marker(carbohydrate antigen 125(CA125),cancer embryo antigen(CEA))levels,vascular endothelial growth factor(VEGF)levels,quality of life and occurrence of adverse reactions were compared between the two groups before and after treatment.Results The total effective rate of the observation group was higher than that of the control(80.00%vs 53.33%,χ2=4.800,P<0.05).After treatment,the levels of CEA,CA125,and VEGF in both groups were reduced,and they were lower in the observation group than in the con-trol((42.32±4.67)ng·mL-1 vs(53.56±5.82)ng·mL-1,(56.03±4.78)U·mL-1 vs(71.63±5.32)U·mL-1,(32.35±5.32)ng·mL-1 vs(46.57±6.38)ng·mL-1)(t=8.250,11.947,9.376,all P<0.05).The physical,role,cognitive,emotional,and social function scores of both groups increased,and they were higher in the observation group than in the control((55.37±5.21)points vs(47.19±4.42)points,(56.28±5.54)points vs(49.61±4.93)points,(57.32±5.63)points vs(51.09±5.07)points,(57.58±5.39)points vs(52.35±5.08)points,(56.46±5.25)points vs(51.15±4.87)points)(t=6.558,4.926,4.504,3.868,4.061,all P<0.05).During the treatment period,there was no statistically obvious difference in the incidence of nausea,vomiting,leukopenia,diarrhea,liver and kidney function damage,thrombocytopenia,rash and bleeding between the two groups(P>0.05).However,the incidence of hypertension in the observation group was 36.67%(11/30),which was higher than that in the control group(χ2=13.469,P<0.05).Conclusion Pemetrexed+cis-platin chemotherapy combined with thoracic hyperthermic perfusion of bevacizumab has good efficacy in patients with advanced NSCLC and pleural effusion.It can reduce the patient's bad mood,optimize the patient's quality of life and has good safety.