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Optimal management of malignant pleural effusions (results of CALGB 30102).

Publication ,  Journal Article
Demmy, TL; Gu, L; Burkhalter, JE; Toloza, EM; D'Amico, TA; Sutherland, S; Wang, X; Archer, L; Veit, LJ; Kohman, L; Cancer and Leukemia Group B,
Published in: J Natl Compr Canc Netw
August 2012

The optimal strategy to achieve palliation of malignant pleural effusions (MPEs) is unknown. This multi-institutional, prospective, randomized trial compares 2 established methods for controlling symptomatic unilateral MPEs. Patients with unilateral MPEs were randomized to either daily tunneled catheter drainage (TCD) or bedside talc pleurodesis (TP). This trial is patterned after a previous randomized trial that showed that bedside TP was equivalent to thoracoscopic TP (CALGB 9334). The primary end point of the current study was combined success: consistent/reliable drainage/pleurodesis, lung expansion, and 30-day survival. A secondary end point, survival with effusion control, was added retrospectively. This trial randomized 57 patients who were similar in terms of age (62 years), active chemotherapy (28%), and histologic diagnosis (lung, 63%; breast, 12%; other/unknown cancers, 25%) to either bedside TP or TCD. Combined success was higher with TCD (62%) than with TP (46%; odds ratio, 5.0; P = .064). Multivariate regression analysis revealed that patients treated with TCD had better 30-day activity without dyspnea scores (8.7 vs. 5.9; P = .036), especially in the subgroup with impaired expansion (9.1 vs. 4.6; P = .042). Patients who underwent TCD had better survival with effusion control at 30 days compared with those who underwent TP (82% vs. 52%, respectively; P = .024). In this prospective randomized trial, TCD achieved superior palliation of unilateral MPEs than TP, particularly in patients with trapped lungs.

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Published In

J Natl Compr Canc Netw

DOI

EISSN

1540-1413

Publication Date

August 2012

Volume

10

Issue

8

Start / End Page

975 / 982

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Talc
  • Quality of Life
  • Prospective Studies
  • Pleurodesis
  • Pleural Effusion, Malignant
  • Oncology & Carcinogenesis
  • Neoplasms
  • Middle Aged
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
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Demmy, T. L., Gu, L., Burkhalter, J. E., Toloza, E. M., D’Amico, T. A., Sutherland, S., … Cancer and Leukemia Group B, . (2012). Optimal management of malignant pleural effusions (results of CALGB 30102). J Natl Compr Canc Netw, 10(8), 975–982. https://doi.org/10.6004/jnccn.2012.0102
Demmy, Todd L., Lin Gu, Jack E. Burkhalter, Eric M. Toloza, Thomas A. D’Amico, Susan Sutherland, Xiaofei Wang, et al. “Optimal management of malignant pleural effusions (results of CALGB 30102).J Natl Compr Canc Netw 10, no. 8 (August 2012): 975–82. https://doi.org/10.6004/jnccn.2012.0102.
Demmy TL, Gu L, Burkhalter JE, Toloza EM, D’Amico TA, Sutherland S, et al. Optimal management of malignant pleural effusions (results of CALGB 30102). J Natl Compr Canc Netw. 2012 Aug;10(8):975–82.
Demmy, Todd L., et al. “Optimal management of malignant pleural effusions (results of CALGB 30102).J Natl Compr Canc Netw, vol. 10, no. 8, Aug. 2012, pp. 975–82. Pubmed, doi:10.6004/jnccn.2012.0102.
Demmy TL, Gu L, Burkhalter JE, Toloza EM, D’Amico TA, Sutherland S, Wang X, Archer L, Veit LJ, Kohman L, Cancer and Leukemia Group B. Optimal management of malignant pleural effusions (results of CALGB 30102). J Natl Compr Canc Netw. 2012 Aug;10(8):975–982.

Published In

J Natl Compr Canc Netw

DOI

EISSN

1540-1413

Publication Date

August 2012

Volume

10

Issue

8

Start / End Page

975 / 982

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Talc
  • Quality of Life
  • Prospective Studies
  • Pleurodesis
  • Pleural Effusion, Malignant
  • Oncology & Carcinogenesis
  • Neoplasms
  • Middle Aged
  • Male