Intrapleural chemotherapy with cisplatin and cytarabine in the management of malignant pleural effusion.
- Author:
Tae Kyu LEE
1
;
Jong Tae BAEK
;
Suk Kyung LEE
;
Sun Woo KIM
;
Kee Won KIM
;
Ji Won SUHR
;
Suk Young PARK
;
Kyung Shick LEE
Author Information
1. Division of Hematology-Oncology, Catholic University of Korea, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Malignant pleural effusion;
Intrapleural chemotherapy
- MeSH:
Chest Tubes;
Cisplatin*;
Cytarabine*;
Drug Therapy*;
Empyema;
Follow-Up Studies;
Humans;
Lung Neoplasms;
Mortality;
Nausea;
Pleural Effusion;
Pleural Effusion, Malignant*;
Prospective Studies;
Radiography, Thoracic;
Recurrence;
Vomiting;
Wound Infection
- From:Korean Journal of Medicine
1999;57(2):191-196
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Maligant pleural effusions are common and significant problems in patient with advanced malignancies. In comparison with traditional sclerosing agent, intrapleural chemotherapy has a potential advantage of treating the underlying malignancy in addition to providing local control of th effusion. This study evaluated efficacy of intrapleural chemotherapy with cisplatin and cytarabine in the management of malignant pleural effusion from lung cancer and others. METHODS: 29 patients with pathology-proven malignant pleural effusion were prospectively analyzed to estimate the effect of intrapleural chemotherapy. A single dose of cisplatin 100mg/m plus cytarabine 1200mg/m in the 250ml normal saline were instilled into the pleural space via a chest tube and drained 4 hours later. Patients were evaluated for toxicity and response at 24hours, 1st, 2nd, 3rd week, and monthly interval. No recurrence of the effusion was considered a complete response(CR). Partial responses (PR) was defined as a 75% or greater decrease in the amount of effusion on serial chest radiographs. RESULTS: The overall response rate(CR plus PR) was 93.1% (27 of 29 patients). The median length of response was 7.5 months. Among 17 patients who were assessable until they died, 14 patients(82%) maintained complete response at the last follow-up. One patient experienced reversible grade 4 myelosuppression, 3 patients had grade 3 nausea & vomiting. 2 patients had empyema, and 2 patients had wound infection. CONCLUSIONS: The outcome of this trial indicated that the intrapleural chemotherapy with cisplatin and cytarabine with little treatment related mortality and morbidity.
