초록접수 현황
| 16F-129 | 구연 발표 |
Chemical Pleurodesis for Malignant Pleural Effusion: Talc vs Mistletoe
YongJin Chang, DeogGon Cho, KyuDo Cho, ChulUng Kang, MinSub Jo
Department of Thoracic and Cardiovascular Surgery, St. Vincent`s Hospital, The Catholic University College of Medicine, Gyeonggi-do, Korea
Background : Many patients diagnosed with advanced cancer have malignant pleural effusion which does not respond to chemotherapy and radiation therapy. These patients often have symptoms, especially dyspnea. In order to relieve dyspnea, a chemical pleurodesis is considered after closed thoracotstomy. In the past, talc was generally used as a sclerosing agent. However, this agent often leads to the complications including ARDS, and make the patient feel discomfort thru pain, fever, leukocytosis. In these days, Mistletoe (ABNOVAviscum® Injection) is introduced as a substitute agent for talc.
Methods : The database consists of 47 patients with malignant pleural effusion who received chemical pleurodesis after closed thoracostomy from January 2003 to March 2016. We were able to analyze clinical course and response after pleurodesis in each agent. The response rate in pleural effusion were assessed by a simple X-ray examination within 4 weeks after the last pleurodesis by known WHO criteria.
Results : In talc group, 11 patients (37.9%) were completely responded to pleurodesis. While, 16 patients (55.2%) had partial response and two patients (6.9%) had no response. In Mistletoe group, 8 patients (47.1%) showed complete response, while 8 patients (47.1%) showed partial response and no response was shown in one patient (5.9%) (p=0.832). After pleurodesis, pain scale (NRS) was 2.7(±1.3) in talc group and 2(±1.3) in Mistletoe group (p=0.152). The changes in white blood cell counts after pleurodesis were 4154.8(±6710.7) in talc group and 2086.5(±6285.2) in Mistletoe group (p=0.307). The changes in CRP were 9.03(±6.86) in talc group and 4.39(±8.26) in Mistletoe group (p=0.203).
Conclusion : In this study, two groups, talc group and Mistletoe group showed no significant data in the therapeutic effect. The Mistletoe group, however, has fewer tendencies to patient feel pain and changes in temperature, white blood cell counts and CRP. We assume that there will be significant data when this study population is larger.
Methods : The database consists of 47 patients with malignant pleural effusion who received chemical pleurodesis after closed thoracostomy from January 2003 to March 2016. We were able to analyze clinical course and response after pleurodesis in each agent. The response rate in pleural effusion were assessed by a simple X-ray examination within 4 weeks after the last pleurodesis by known WHO criteria.
Results : In talc group, 11 patients (37.9%) were completely responded to pleurodesis. While, 16 patients (55.2%) had partial response and two patients (6.9%) had no response. In Mistletoe group, 8 patients (47.1%) showed complete response, while 8 patients (47.1%) showed partial response and no response was shown in one patient (5.9%) (p=0.832). After pleurodesis, pain scale (NRS) was 2.7(±1.3) in talc group and 2(±1.3) in Mistletoe group (p=0.152). The changes in white blood cell counts after pleurodesis were 4154.8(±6710.7) in talc group and 2086.5(±6285.2) in Mistletoe group (p=0.307). The changes in CRP were 9.03(±6.86) in talc group and 4.39(±8.26) in Mistletoe group (p=0.203).
Conclusion : In this study, two groups, talc group and Mistletoe group showed no significant data in the therapeutic effect. The Mistletoe group, however, has fewer tendencies to patient feel pain and changes in temperature, white blood cell counts and CRP. We assume that there will be significant data when this study population is larger.
책임저자: DeogGon Cho
Department of Thoracic and Cardiovascular Surgery, St. Vincent`s Hospital, The Catholic University College of Medicine, Gyeonggi-do, Korea
발표자: YongJin Chang, E-mail : tsmate@hanmail.net