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医学胸腔镜引导下腔内多西紫杉醇治疗非小细胞肺癌恶性胸腔积液的疗效:一项初步研究。

Effect of medical thoracoscopy-guided intrapleural docetaxel therapy to manage malignant pleural effusion in patients with non-small cell lung cancer: A pilot study.

机构信息

Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.

Division of Pulmonary and Critical care medicine, Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, South Korea.

出版信息

Thorac Cancer. 2019 Oct;10(10):1885-1892. doi: 10.1111/1759-7714.13158. Epub 2019 Aug 6.

Abstract

BACKGROUND

Although chemical pleurodesis is a useful treatment option for malignant pleural effusion, little is known about the effects of intrapleural docetaxel therapy.

OBJECTIVES

This study aimed to evaluate the effects of medical thoracoscopy-guided intrapleural docetaxel therapy in patients with lung cancer.

METHODS

Patients with lung cancer who diagnosed malignant pleural effusion were enrolled in this single-center prospective pilot study. The clinical response and toxicity were evaluated at two, six and 12 weeks post-treatment.

RESULTS

Medical thoracoscopy-guided intrapleural docetaxel therapy was conducted in four patients between June 2016 and August 2017. The control rate of malignant pleural effusion was 100% (4/4), and the progression-free duration of effusion was 527 ± 109 days. No serious adverse events were observed, but only mild-to-moderate adverse events were observed and well controlled by conservative management. Although the overall quality of life assessed using questionnaires did not show significant improvement, symptom burden due to dyspnea was significantly improved.

CONCLUSIONS

Intrapleural docetaxel therapy with medical thoracoscopy showed good clinical responses, relieving dyspnea symptoms and providing tolerable safety profiles in patients with non-small cell lung cancer (NSCLC) with malignant pleural effusion. A further prospective trial is warranted to evaluate the clinical effects of intrapleural docetaxel therapy in order to compare it with other treatment modalities.

摘要

背景

虽然化学性胸膜固定术是治疗恶性胸腔积液的有效方法,但对于胸腔内多西紫杉醇治疗的效果知之甚少。

目的

本研究旨在评估胸腔镜引导下胸腔内多西紫杉醇治疗肺癌患者的效果。

方法

本单中心前瞻性试点研究纳入了诊断为恶性胸腔积液的肺癌患者。在治疗后 2、6 和 12 周时评估临床反应和毒性。

结果

2016 年 6 月至 2017 年 8 月期间,对 4 例患者进行了胸腔镜引导下胸腔内多西紫杉醇治疗。恶性胸腔积液的控制率为 100%(4/4),胸腔积液无进展时间为 527±109 天。未观察到严重不良事件,但仅观察到轻度至中度不良事件,并通过保守治疗得到良好控制。虽然使用问卷评估的整体生活质量没有显著改善,但呼吸困难的症状负担得到了显著改善。

结论

胸腔镜引导下胸腔内多西紫杉醇治疗在非小细胞肺癌(NSCLC)合并恶性胸腔积液患者中显示出良好的临床反应,缓解呼吸困难症状,并具有可耐受的安全性。需要进一步的前瞻性试验来评估胸腔内多西紫杉醇治疗的临床效果,以便将其与其他治疗方法进行比较。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c3b3/6775018/a572328e273b/TCA-10-1885-g001.jpg

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