Journal of Chest Surgery

  • 제56권5호
  • /
  • Pages.353-358
  • /
  • 2023
  • /
  • 2765-1606(pISSN)
  • /
  • 2765-1614(eISSN)
대한심장혈관흉부외과학회 (The Korean Society for Thoracic and Cardiovascular Surgery)
권호 표지
DOI QR코드

DOI QR Code

Which is the More Effective Option for Pleurodesis to Prevent the Recurrence of Malignant Pleural Effusion? Large-Particle Talc or Mistletoe Extract (ABNOVA Viscum Injection)

  • Changsung Han (Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Jonggeun Lee (Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Jeong Su Cho (Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Hyo Yeong Ahn (Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, Pusan National University School of Medicine)
  • 투고 : 2023.03.07
  • 심사 : 2023.07.06
  • 발행 : 2023.09.05
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Background: Malignant pleural effusion affects many patients with advanced cancer. When chemotherapy or radiotherapy fails to relieve malignant pleural effusion and related symptoms, drainage and pleurodesis can help. Although surgical talc pleurodesis is the most widely used method, Viscum album, which has been recently used in surgical or bedside procedures, has demonstrated significant results and is as effective as talc. This study aimed to determine the most effective agent and procedure. Methods: Between January 2015 and July 2022, chemical pleurodesis was performed in 137 patients with malignant pleural effusion, using a V. album surgical procedure in 48, a V. album bedside procedure in 55, and a talc surgical procedure in 34 patients. We reviewed patients' clinical responses and disease progression after chemical pleurodesis. Results: The success rate was not significantly different among the V. album surgical procedures (91.7%), V. album bedside procedures (83.6%), and talc surgical procedures (91.2%). However, the total drainage amount and tube insertion duration in both Viscum groups were more effective than those in the talc group. Furthermore, the bedside Viscum group showed significantly lower post-pleurodesis pain scores than the other 2 groups. Conclusion: According to our results, talc and V. album can be considered ideal agents for chemical pleurodesis. However, Viscum pleurodesis showed safer outcomes in terms of ensuring quality of life than talc. Additionally, the bedside Viscum group showed significantly lower pain scores than the other groups. Hence, patients for whom surgical procedures are inappropriate can undergo bedside Viscum pleurodesis without diminishing the therapeutic effect.

키워드

과제정보

This work was supported by a clinical research grant from Pusan National University Hospital in 2023.

참고문헌

  1. El-Kolaly RM, Abo-Elnasr M, El-Guindy D. Outcome of pleurodesis using different agents in management of malignant pleural effusion. Egypt J Chest Dis Tuberc 2016;65:435-40. https://doi.org/10.1016/j.ejcdt.2015.12.017
  2. Eom JS, Ahn HY, Mok JH, et al. Pleurodesis using mistletoe extract delivered via a spray catheter during semirigid pleuroscopy for managing symptomatic malignant pleural effusion. Respiration 2018;95:177-81. https://doi.org/10.1159/000481869
  3. Chang Y, Cho D, Cho K, Cho M. Viscum pleurodesis is as effective as talc pleurodesis and tends to have less adverse effect. Support Care Cancer 2020;28:5463-7. https://doi.org/10.1007/s00520-020-05405-0
  4. Loizzi D, Sollitto F, Piazzolla M, Ardo NP. Thoracoscopic pleurodesis using talc poudrage versus cytotoxic drug in malignant pleural effusion: narrative review. J Xiangya Med 2021;6:6. https://doi.org/10.21037/jxym-20-67
  5. Cho JS, Na KJ, Lee Y, et al. Chemical pleurodesis using mistletoe extraction (ABNOVAviscum(R) injection) for malignant pleural effusion. Ann Thorac Cardiovasc Surg 2016;22:20-6. https://doi.org/10.5761/atcs.oa.15-00230
  6. Roberts ME, Neville E, Berrisford RG, Antunes G, Ali NJ; BTS Pleural Disease Guideline Group. Management of a malignant pleural effusion: British Thoracic Society Pleural Disease Guideline 2010. Thorax 2010;65 Suppl 2:ii32-40. https://doi.org/10.1136/thx.2010.136994
  7. Tan C, Sedrakyan A, Browne J, Swift S, Treasure T. The evidence on the effectiveness of management for malignant pleural effusion: a systematic review. Eur J Cardiothorac Surg 2006;29:829-38. https://doi.org/10.1016/j.ejcts.2005.12.025
  8. Shaw P, Agarwal R. Pleurodesis for malignant pleural effusions. Cochrane Database Syst Rev 2004;(1):CD002916. https://doi.org/10.1002/14651858.CD002916.pub2
  9. Rahman NM, Ali NJ, Brown G, et al. Local anaesthetic thoracoscopy: British Thoracic Society Pleural Disease Guideline 2010. Thorax 2010;65 Suppl 2:ii54-60. https://doi.org/10.1136/thx.2010.137018
  10. Stefani A, Natali P, Casali C, Morandi U. Talc poudrage versus talc slurry in the treatment of malignant pleural effusion: a prospective comparative study. Eur J Cardiothorac Surg 2006;30:827-32. https://doi.org/10.1016/j.ejcts.2006.10.002