The Efficacy of Various Management Options for Malignant Pleural Effusions
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Malignant pleural effusion (MPE) may be the first manifestation of the neoplastic disease or its complication.The aim of the study was determining the most effective management, comparison of the efficacy of various therapeutic options, evaluation of treatment results.Material and methods. Between 1996 and 2003, 150 patients were treated in the Wrocław Thoracic Surgery Centre. Lung cancer was diagnosed in 61 (40.7%), other malignancy in 82 (54.7%), primary focus was not established in 7 (4.7%) patients. There were following groups. Group I (n=39): patients who underwent pleurodesis with Bleomycin (60 mg), group II (n=36) - Doxycylin (1 g or 0,5 g), group III (n=52) - Talc (4 g), group IV (n=12) - politherapy, group V (n=11) - other patients.Results. Patients from group I - IV were undergone statistical analysis. This group was divided into subgroup A (n=24, patients who died within first month) and subgroup B (n=115, who lived longer). In subgroup A total remission was achieved in I - 100%, in II - 70%, in III - 100%. The worst results were obtained in group II, but there weren't SSD between groups (p>0,05). In subgroup B total remission was analyzed after 1, 3, 6, 9 months. Total remission after 9 months was achieved in I - 85,2%, in II - 69,2%, in III - 98%, in IV - 91,7%. SSD occurred between groups I and III (p=0,0327), II and III (p<0.001). Median mean rate survival was in I - 239, in II - 232, in III - 267, in IV - 207 days (p>0,05). Drainage complications and signs effect were analyzed.Conclusions. The best results were achieved after using Talc. In instance of difficulties of inhibition MPE we should apply politherapy. There weren't SSD in survival length between groups. The most common signs effect was pain, which occurred more frequent after instillation of Doxycyline and Talc than Bleomycin and fever which occurred the most frequent after instillation Talc and after politherapy
1 - 3 - 2007
24 - 9 - 2007
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