4yr
Intrapleural treatment in patients with non-small cell lung cancer with malignant pleural effusions in the real world - PubMed
Source : https://pubmed.ncbi.nlm.nih.gov/34741494/
doi: 10.1111/1759-7714.14224. Online ahead of print. 1 Department of Pulmonary and Critical Care Medicine, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China. 2 Department of Pulmonary and Critical Care Medicine, Heze Municipal Hospital, Heze, China. 3 Department of Pulmonary and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, China.
• Source: Thoracic Cancer
• Conclusion/Relevance: “Intrapleural treatment can prolong the survival of NSCLC patients with MPE (malignant pleural effusions) who do not receive targeted treatment or who only receive chemotherapy. The PE-CEA: B-CEA ratio can be used to predict the efficacy if intrapleural treatment is indicated.”
• In this retrospective study, Chinese investigators assessed 285 cases, with 81.1% of patients administered intrapleural treatment and no patients receiving talc pleurodesis. The median overall survival (MOS) was 21 months.
• Patients were divided into the following groups: the erythromycin group (EG or intrapleural treatment with drugs and erythromycin); intrathoracic treatment group (ITG or intrapleural treatment with drugs); or control group (CG or no drug treatment in the pleural cavity). The MOS of the EG group was 20 months, that of the ITG group was 22 months, and that of the CG group was 19 months.
• In patients who were administered only chemotherapy as systemic therapy, the MOS of intrathoracic administration group (i.e., EG and ITG) was longer than that of the control group. Furthermore, the MOS of patients with a ratio of carcinoembryonic antigen in pleural effusion (PE-CEA): CEA in blood (B-CEA) ≤1 was lower than than that of patients with a ratio >1 and controls.
• The authors noted that the real-world treatment of NSCLC patients with MPE varies from that recommended in guidelines. This variation is mostly due to a large number of patients receiving intrapleural treatment. Intrapleural treatment can lengthen the survival of NSCLC patients with MPE who are not administered targeted therapy or who receive only systemic chemotherapy. Of note, not all NSCLC patients with MPE derived benefit from intrapleural treatment. If intrapleural treatment is recommended, the PE-CEA: B-CEA ratio can be used to predict its efficacy.
• One main limitation of the current study is its retrospective nature, with a lack of some data. This study also collected many variables of patients, with the inclusion of confounding variables a possibility.