Korsic Marta, Badovinac Sonja, Cucevic Branka, Janevski Zoran
University Hospital for Lung Diseases "Jordanovac", Jordanovac 104, HR-10000, Zagreb, Croatia.
Wien Klin Wochenschr. 2015 Dec;127(23-24):963-9. doi: 10.1007/s00508-015-0716-8. Epub 2015 Apr 10.
The aim of this study is to investigate whether there was a considerable difference in the survival of patients with malignant pleural effusion (MPE) depending on the pleural effusion treatment option.
One hundred and seven patients with proven MPE (metastatic lung and breast cancer) were included in the retrospective study. Fifty six patients were treated with talc pleurodesis and a control group of 51 patients with similar characteristics (in age, sex and disease) were treated with serial thoracentesis. The patients of both groups underwent chemotherapy and/or radiotherapy. The overall survival and the survival in subgroups of patients with different tumour types and different performance status (PS) equal 1, 2 and 3 were compared.
The patients who underwent talc pleurodesis had a longer average survival interval (MS) than the patients without such a treatment (n = 56; MS = 21,5 and n = 51; MS = 9 weeks, respectively; p < 0.001). The best results were achieved in patients with PS 1 (n = 16; MS = 35.5 and n = 10; MS = 11 weeks in the groups with and without talc pleurodesis, respectively; p < 0,001) and PS 2 (n = 27; MS = 21 and n = 30; MS = 10 weeks in the groups with and without talc pleurodesis, respectively; p < 0.001), whereas talc pleurodesis was not effective in PS 3 patients (n = 13; MS = 10 and n = 11; MS = 7 weeks in the groups with and without talc pleurodesis, respectively; p = 0.08). Patients with the breast cancer showed a longer average survival interval after pleurodesis than those with the lung cancer (n = 12; MS = 37.5 and n = 4; MS = 20 weeks in the group with the breast cancer and with the lung cancer, respectively; p < 0.001), whereas the median survival was not significantly different between those patients without pleurodesis (n = 10; MS = 10 and n = 41; MS = 9 weeks in the group with the breast cancer and lung cancer, respectively; p = 0.11).
The patients treated with talc pleurodesis had a significantly longer average survival than the patients without such a treatment, especially in the group with the breast cancer and in groups with better performance status. This may indicate that talc pleurodesis, apart from its symptomatic effect on the cessation of pleural effusion, may have a direct antitumour effect as well.
本研究旨在调查恶性胸腔积液（MPE）患者的生存情况是否因胸腔积液治疗方案的不同而存在显著差异。
107例经证实的MPE患者（转移性肺癌和乳腺癌）纳入回顾性研究。56例患者接受滑石粉胸膜固定术治疗，51例具有相似特征（年龄、性别和疾病）的患者作为对照组接受系列胸腔穿刺术治疗。两组患者均接受化疗和/或放疗。比较了总体生存率以及不同肿瘤类型和不同体能状态（PS）为1、2和3的亚组患者的生存率。
接受滑石粉胸膜固定术的患者平均生存间隔（MS）比未接受该治疗的患者更长（分别为n = 56；MS = 21.5周和n = 51；MS = 9周；p < 0.001）。PS为1的患者（分别为n = 16；MS = 35.5周和n = 10；MS = 11周，滑石粉胸膜固定术组和未接受该治疗组）和PS为2的患者（分别为n = 27；MS = 21周和n = 30；MS = 10周，滑石粉胸膜固定术组和未接受该治疗组）取得了最佳结果，而滑石粉胸膜固定术对PS为3的患者无效（分别为n = 13；MS = 10周和n = 11；MS = 7周，滑石粉胸膜固定术组和未接受该治疗组；p = 0.08）。乳腺癌患者胸膜固定术后的平均生存间隔比肺癌患者更长（分别为n = 12；MS = 37.5周和n = 4；MS = 20周，乳腺癌组和肺癌组），而未接受胸膜固定术的患者之间的中位生存期无显著差异（分别为n = 10；MS = 10周和n = 41；MS = 9周，乳腺癌组和肺癌组；p = 0.11）。
接受滑石粉胸膜固定术治疗的患者平均生存期明显长于未接受该治疗的患者，尤其是乳腺癌组和体能状态较好的组。这可能表明滑石粉胸膜固定术除了对胸腔积液停止有对症作用外，可能还具有直接的抗肿瘤作用。
