No abstract available.
Cisplatin* ; Cytarabine* ; Drug Therapy* ; Pleural Effusion, Malignant*

Malignant pleural effusion (MPE) can occur in nearly all types of malignant tumors, with lung cancer being the most prevalent cause. The presence of MPE indicates an advanced stage or distant spread of the tumor, significantly reducing the patient's life expectancy. Particularly, a substantial amount of pleural effusion can impede heart and lung function, impair blood oxygen perfusion levels in the body, and greatly diminish patients' quality of life. Even when systemic treatment has alleviated the primary lung tumor in some patients, effective control over MPE remains challenging and impacts clinical outcomes. Therefore, it is crucial to implement measures for reducing or managing MPE while ensuring standardized treatment for lung cancer. In recent years, significant advancements have been made in diagnosing and treating lung cancer complicated by MPE through extensive basic and clinical research. Based on existing evidence and China's clinical practice experience, relevant experts from the China Association of Health Promotion and Education and Cancer Rehabilitation and Palliative Treatment Professional Committee of China Anti-Cancer Association (CRPC) have summarized key aspects related to diagnosis and treatment consensus opinions for lung cancer complicated by MPE. This aims to establish standardized procedures that will serve as a reference for doctors' clinical practice.
Humans ; Lung Neoplasms/diagnosis* ; Pleural Effusion, Malignant/therapy* ; Consensus ; Quality of Life ; Pleural Effusion/therapy*

Malignant pleural effusion in multiple myeloma (MM) is extremely rare and is associated with poor prognosis. We experienced two cases of MM IgA type with malignant pleural effusion. The diagnoses were based on characteristic cytology and CD138 immunocytochemistry. The patients received several cycles of combination chemotherapy, since symptoms were more aggressive with an uncontrolled pleural effusion. We review the clinical features of these cases and literature concerning myelomatous pleural effusion.
Drug Therapy, Combination ; Humans ; Immunoglobulin A ; Immunohistochemistry ; Multiple Myeloma ; Pleural Effusion ; Pleural Effusion, Malignant ; Prognosis

Locally advanced NSCLC is a heterogenous group of bronchogenic malignancies that are traditionally thought to be unresectable without overt distant metastasis or malignant pleural effusion. The mainstay of treatment for this class of diseases until the early 1990s was radiation alone, which resulted in a dismal outcome. The new technologies in radiation therapy (e.g. 3D-CRT) and the shift in paradigm (e.g. omission of ENI) have enabled the dose-escalation, which translated to improved outcome compared to the conventional radiotherapy using 2-D planning. The trials combining chemotherapy with radiotherapy, first sequentially, then concurrently, have changed the standard of care for patients with good functional status to concurrent chemoradiation. Some studies have shown survival benefits to adding consolidative systemic therapy with concurrent chemoradiation. We will outline the development of the current treatment standard of locally advanced NSCLC and present selected topics undergoing active research to forecast the next generation of NSCLC therapy
Carcinoma, Non-Small-Cell Lung* ; Drug Therapy ; Humans ; Neoplasm Metastasis ; Pleural Effusion, Malignant ; Radiotherapy ; Standard of Care

Carcinomas of the lung, breast and lymphoma account for approximately 75% of malignant pleural effusions and the metastatic ovarian carcinoma is the fourth leading cause of malignant pleural effusions. The diagnosis of a malignant pleural effusion is established by demonstrating malignant cells in the pleural fluid or in the pleural biopsy. Chemical pleurodesis should be considered in cases of patients with malignant pleural effusion, who were not responded with systemic chemotherapy. We experienced a case of malignant pleural effusion treated by chemical pleurodesis, which was developed in a patient with ovarian carcinoma and we report it with the brief review or literatures.
Biopsy ; Breast ; Diagnosis ; Drug Therapy ; Humans ; Lung ; Lymphoma ; Pleural Effusion, Malignant* ; Pleurodesis*

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.
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

Malignant melanoma develops from melanocytes and frequently metastases to other organs. Common metastatic sites are other skin, lymph nodes, lung, liver, brain and bone in decreasing order of frequency. Malignant pleural effusion is less frequent manifestation of thoracic metastasis. We experienced a 57-year-old man with pleural effusion who received radical resection with local flap on left foot due to acral lentiginous melanoma 3 years ago. He had progressive chest pain and left massive pleural effusion. The pleural cytology and biopsy showed malignant melanoma. After closed thoracostomy and talc pleurodesis, he refused further immunotherapy and chemotherapy and discharged.
Biopsy ; Brain ; Chest Pain ; Drug Therapy ; Foot ; Humans ; Immunotherapy ; Liver ; Lung ; Lymph Nodes ; Melanocytes ; Melanoma* ; Middle Aged ; Neoplasm Metastasis* ; Pleural Effusion* ; Pleural Effusion, Malignant ; Pleurodesis ; Skin ; Talc ; Thoracostomy

PURPOSE: The purpose of this study was to evaluate the efficacy of intrapleural chemotherapy (IPC) with cisplatin and cytarabine in the management of malignant pleural effusion (MPE) from non-small-cell lung cancer (NSCLC). MATERIALS AND METHODS: A prospective analysis was carried out on 40 patients with pathologically proven MPE from NSCLC who had received IPC. A single dose of cisplatin 100 mg/m2 plus cytarabine 1200 mg/m2 in 250 ml normal saline was instilled into the pleural space via a chest tube and drained 4 hours later. Patients were evaluated for toxicities and responses at 1, 2, & 3 weeks and then at monthly intervals if possible. Systemic chemotherapy was administered, if the patient agreed to receive it, after achieving complete control (CC) of MPE. RESULTS: The median duration of chest tube insertion for drainage was 7 (3~32) days. Among the assessable 37 patients, CC and partial control (PC) were 32 (86.5%) and 4 (10.8%) patients, respectively (overall response rate 97.3%). The median duration of response was 12 months (2~23) and there were only two relapses of IPC after achieving CC. Among the 35 patients who were assessable until they died, 28 patients (80.0%) maintained CC until the last follow-up. There was only one toxic death and the toxicities of IPC, versus the results obtained, were deemed acceptable. CONCLUSION: The procedures were tolerable to the patients and chemotherapy-induced complications were at an acceptable level. The outcome of this trial indicates that IPC has a superior and long lasting treatment response in the management of patients with MPE from NSCLC.
Chest Tubes ; Cisplatin* ; Cytarabine* ; Drainage ; Drug Therapy* ; Follow-Up Studies ; Humans ; Lung Neoplasms ; Pleural Effusion ; Pleural Effusion, Malignant* ; Prospective Studies ; Recurrence

Fibrinolytic Agents ; therapeutic use ; Humans ; Lung Neoplasms ; complications ; Mesothelioma ; complications ; Pleural Effusion, Malignant ; drug therapy ; Streptokinase ; therapeutic use

Lung cancer is the most commonly diagnosed cancer worldwide. Malignant pleural effusion (MPE) caused by advanced lung cancer seriously affect the patients' quality of life and prognosis. The management of MPE includes thoracentesis, pleurodesis, indwelling pleural catheters and drug perfusion in pleural cavity. Vascular endothelial growth factor (VEGF) and its receptor are a group of important ligands and receptors that affect angiogenesis. They are the main factors controlling angiogenesis, and they play an important role in the formation of MPE. Bevacizumab is a recombinant humanized VEGF monoclonal antibody, competitively binding to endogenous VEGF receptor. Bevacizumab can inhibit new blood vessel formation, reduce vascular permeability, prevent pleural effusion accumulation and slow the growth of cancers. This review aims to discuss the progress of bevacizumab in the treatment of MPE caused by non-small cell lung cancer (NSCLC), and explore the clinical application, efficacy, safety and future direction of bevacizumab.
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Antineoplastic Agents ; therapeutic use ; Antineoplastic Agents, Immunological ; therapeutic use ; Carcinoma, Non-Small-Cell Lung ; complications ; pathology ; Humans ; Pleural Effusion, Malignant ; drug therapy ; Pleural Neoplasms ; drug therapy ; secondary