Better effect of intrapleural perfusion with hyperthermic chemotherapy by video‐assisted thoracoscopic surgery for malignant pleural effusion treatment compared to normothermic chemoperfusion of the pleural cavity

Autor: Jinyi Wang, Guohan Chen, Guangxue Wang, Xuan Hong, Zhiyuan Huang, Tian Zhao, Yejun Cao, Qiying Zhang, Zhengjun Chai, Jie Liu, Qinchuan Li, Yang Han, Zhengliang Sun
Rok vydání: 2021
Předmět:
Male
Cancer Research
medicine.medical_specialty
curative effect
Pleural effusion
medicine.medical_treatment
Antineoplastic Agents
Kaplan-Meier Estimate
intrapleural perfusion with hyperthermic chemotherapy (IPHC)
malignant pleural effusion (MPE)
medicine
Humans
Malignant pleural effusion
Radiology
Nuclear Medicine and imaging
RC254-282
Research Articles
Survival analysis
Aged
Proportional Hazards Models
normothermic chemoperfusion of the pleural cavity
Pleural Cavity
Chemotherapy
Thoracic Surgery
Video-Assisted
Proportional hazards model
business.industry
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Clinical Cancer Research
Hyperthermia
Induced
Middle Aged
Pleural cavity
medicine.disease
Pleural Effusion
Malignant
Surgery
Perfusion
Exact test
Treatment Outcome
medicine.anatomical_structure
Oncology
Video-assisted thoracoscopic surgery
Female
business
Research Article
Zdroj: Cancer Medicine
Cancer Medicine, Vol 11, Iss 2, Pp 348-357 (2022)
ISSN: 2045-7634
DOI: 10.1002/cam4.4450
Popis: Objective The aim of this study was to assess the efficacy and safety of intrapleural perfusion with hyperthermic chemotherapy (IPHC) in treating malignant pleural effusion (MPE) compared to normothermic chemoperfusion of the pleural cavity (NCPC), and to investigate the better treatment to control MPE. Methods Malignant pleural effusion patients were enrolled in the study and treated with NCPC or IPHC under video‐assisted thoracoscopic surgery (VATS). The chest drainage duration, clinical characteristics, and recurrence time of pleural effusion of patients were collected for statistical analysis. The chi‐squared test and the Fisher's exact test were applied to compare the distribution differences in categorical variables. Progression‐free survival (PFS) was estimated by the Kaplan–Meier method and was compared by the log‐rank test. The survival analysis was performed using the Cox proportional hazards method. Results A total of 37 MPE patients were enrolled in this study. Twenty‐seven patients received NCPC and 10 patients received IPHC under VATS. Significant differences were found in pathological types (p = 0.011), chest drainage duration (p = 0.005), and remission rate (p = 0.009) between two different treatment groups. The chest drainage duration of IPHC under VATS was shorter than the NCPC group (t = 2.969, p = 0.005). The remission rate of MPE in IPHC group was better than the NCPC one (OR = 0.031, 95% CI: 0.002–0.507, p = 0.015). The result of the Kaplan–Meier method showed that IPHC group could significantly prolong the PFS of patients with MPE compared to NCPC group (log‐rank p = 0.002). Univariate cox regression analysis showed that patients with MPE in the IPHC group presented significant longer PFS than the NCPC group (HR = 0.264, 95% CI: 0.098–0.713, p = 0.009). Multivariate cox regression analysis further verified this conclusion (HR = 0.268, 95% CI: 0.096–0.753, p = 0.012). Conclusion Compared to the NCPC, the IPHC under VATS presents a better control effect on MPE, shorter tube placement time, and longer complete remission time. For this reason, we recommend IPHC under VATS as the first‐line treatment for patients with MPE those who can tolerate minimally invasive surgery.
There have been some reports on the efficacy of intrapleural perfusion with hyperthermic chemotherapy (IPHC) in the treatment of malignant pleural effusion (MPE), but few studies put emphasis on IPHC under video‐assisted thoracoscopic surgery (VATS) and the efficacy of different treatment regimens. This study aims to explore the curative effect of IPHC under VATS and normothermic chemoperfusion of the pleural cavity (NCPC) in the treatment of MPE, and to provide clinical experience for MPE.
Databáze: OpenAIRE
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