Clinical outcomes of chemical pleurodesis using a minocycline

Li Han Hsu, An Chen Feng, Thomas C. Soong, Jen Sheng Ko, Nei Min Chu, Yung Feng Lin, Shu Huei Kao

研究成果: 雜誌貢獻文章

摘要

Background: Pleurodesis is often used to prevent the re-accumulation of a malignant pleural effusion (MPE). Intrapleural urokinase (IPUK) therapy facilitates lung re-expansion for patients with loculated MPE or a trapped lung that allows subsequent pleurodesis. MPE management has been traditionally regarded as a symptomatic treatment. We tried to evaluate their impact on patient survival. Methods: There were 314 consecutive patients with symptomatic MPE that underwent minocycline pleurodesis with (n = 109) and without (n = 205) the antecedent IPUK therapy between September 2005 and August 2015, who were recruited for the pleurodesis outcome and survival analysis. Results: The rate of successful pleurodesis was similar between the simple pleurodesis group and the IPUK therapy group followed by the pleurodesis group (69.0% versus 70.5%; p = 0.804). The patients who succeeded pleurodesis had a longer survival rate than those who failed in either the simple pleurodesis group (median, 414 versus 100 days; p < 0.001) or the IPUK therapy followed by pleurodesis group (259 versus 102 days; p < 0.001). The survival differences remained when the lung and breast cancer patients were studied separately. Conclusion: Successful pleurodesis translated into a better survival rate that promotes performing pleurodesis on lung re-expansion. The apparent shorter survival of the patients with loculated MPE or trapped lung, and those that did not respond to the IPUK therapy, lowered the probability of the survival benefit through the simple physical barrier by the fibrin formation to prevent the tumor spreading. The successfully induced inflammatory response by minocycline is supposed to prohibit the tumor invasion and metastasis. Further studies are warranted to clarify the mechanism and provide opportunities to develop novel therapeutic strategies.
原文英語
頁(從 - 到)1753466619841231
期刊Therapeutic Advances in Respiratory Disease
13
DOIs
出版狀態已發佈 - 四月 5 2019

指紋

Pleurodesis
Minocycline
Malignant Pleural Effusion
Urokinase-Type Plasminogen Activator
Lung
Survival
Therapeutics
Survival Rate
Architectural Accessibility
Survival Analysis
Group Psychotherapy
Fibrin
Lung Neoplasms
Neoplasms

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Pharmacology (medical)

引用此文

Clinical outcomes of chemical pleurodesis using a minocycline. / Hsu, Li Han; Feng, An Chen; Soong, Thomas C.; Ko, Jen Sheng; Chu, Nei Min; Lin, Yung Feng; Kao, Shu Huei.

於: Therapeutic Advances in Respiratory Disease, 卷 13, 05.04.2019, p. 1753466619841231.

研究成果: 雜誌貢獻文章

Hsu, Li Han ; Feng, An Chen ; Soong, Thomas C. ; Ko, Jen Sheng ; Chu, Nei Min ; Lin, Yung Feng ; Kao, Shu Huei. / Clinical outcomes of chemical pleurodesis using a minocycline. 於: Therapeutic Advances in Respiratory Disease. 2019 ; 卷 13. 頁 1753466619841231.
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title = "Clinical outcomes of chemical pleurodesis using a minocycline",
abstract = "Background: Pleurodesis is often used to prevent the re-accumulation of a malignant pleural effusion (MPE). Intrapleural urokinase (IPUK) therapy facilitates lung re-expansion for patients with loculated MPE or a trapped lung that allows subsequent pleurodesis. MPE management has been traditionally regarded as a symptomatic treatment. We tried to evaluate their impact on patient survival. Methods: There were 314 consecutive patients with symptomatic MPE that underwent minocycline pleurodesis with (n = 109) and without (n = 205) the antecedent IPUK therapy between September 2005 and August 2015, who were recruited for the pleurodesis outcome and survival analysis. Results: The rate of successful pleurodesis was similar between the simple pleurodesis group and the IPUK therapy group followed by the pleurodesis group (69.0{\%} versus 70.5{\%}; p = 0.804). The patients who succeeded pleurodesis had a longer survival rate than those who failed in either the simple pleurodesis group (median, 414 versus 100 days; p < 0.001) or the IPUK therapy followed by pleurodesis group (259 versus 102 days; p < 0.001). The survival differences remained when the lung and breast cancer patients were studied separately. Conclusion: Successful pleurodesis translated into a better survival rate that promotes performing pleurodesis on lung re-expansion. The apparent shorter survival of the patients with loculated MPE or trapped lung, and those that did not respond to the IPUK therapy, lowered the probability of the survival benefit through the simple physical barrier by the fibrin formation to prevent the tumor spreading. The successfully induced inflammatory response by minocycline is supposed to prohibit the tumor invasion and metastasis. Further studies are warranted to clarify the mechanism and provide opportunities to develop novel therapeutic strategies.",
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author = "Hsu, {Li Han} and Feng, {An Chen} and Soong, {Thomas C.} and Ko, {Jen Sheng} and Chu, {Nei Min} and Lin, {Yung Feng} and Kao, {Shu Huei}",
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T1 - Clinical outcomes of chemical pleurodesis using a minocycline

AU - Hsu, Li Han

AU - Feng, An Chen

AU - Soong, Thomas C.

AU - Ko, Jen Sheng

AU - Chu, Nei Min

AU - Lin, Yung Feng

AU - Kao, Shu Huei

PY - 2019/4/5

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N2 - Background: Pleurodesis is often used to prevent the re-accumulation of a malignant pleural effusion (MPE). Intrapleural urokinase (IPUK) therapy facilitates lung re-expansion for patients with loculated MPE or a trapped lung that allows subsequent pleurodesis. MPE management has been traditionally regarded as a symptomatic treatment. We tried to evaluate their impact on patient survival. Methods: There were 314 consecutive patients with symptomatic MPE that underwent minocycline pleurodesis with (n = 109) and without (n = 205) the antecedent IPUK therapy between September 2005 and August 2015, who were recruited for the pleurodesis outcome and survival analysis. Results: The rate of successful pleurodesis was similar between the simple pleurodesis group and the IPUK therapy group followed by the pleurodesis group (69.0% versus 70.5%; p = 0.804). The patients who succeeded pleurodesis had a longer survival rate than those who failed in either the simple pleurodesis group (median, 414 versus 100 days; p < 0.001) or the IPUK therapy followed by pleurodesis group (259 versus 102 days; p < 0.001). The survival differences remained when the lung and breast cancer patients were studied separately. Conclusion: Successful pleurodesis translated into a better survival rate that promotes performing pleurodesis on lung re-expansion. The apparent shorter survival of the patients with loculated MPE or trapped lung, and those that did not respond to the IPUK therapy, lowered the probability of the survival benefit through the simple physical barrier by the fibrin formation to prevent the tumor spreading. The successfully induced inflammatory response by minocycline is supposed to prohibit the tumor invasion and metastasis. Further studies are warranted to clarify the mechanism and provide opportunities to develop novel therapeutic strategies.

AB - Background: Pleurodesis is often used to prevent the re-accumulation of a malignant pleural effusion (MPE). Intrapleural urokinase (IPUK) therapy facilitates lung re-expansion for patients with loculated MPE or a trapped lung that allows subsequent pleurodesis. MPE management has been traditionally regarded as a symptomatic treatment. We tried to evaluate their impact on patient survival. Methods: There were 314 consecutive patients with symptomatic MPE that underwent minocycline pleurodesis with (n = 109) and without (n = 205) the antecedent IPUK therapy between September 2005 and August 2015, who were recruited for the pleurodesis outcome and survival analysis. Results: The rate of successful pleurodesis was similar between the simple pleurodesis group and the IPUK therapy group followed by the pleurodesis group (69.0% versus 70.5%; p = 0.804). The patients who succeeded pleurodesis had a longer survival rate than those who failed in either the simple pleurodesis group (median, 414 versus 100 days; p < 0.001) or the IPUK therapy followed by pleurodesis group (259 versus 102 days; p < 0.001). The survival differences remained when the lung and breast cancer patients were studied separately. Conclusion: Successful pleurodesis translated into a better survival rate that promotes performing pleurodesis on lung re-expansion. The apparent shorter survival of the patients with loculated MPE or trapped lung, and those that did not respond to the IPUK therapy, lowered the probability of the survival benefit through the simple physical barrier by the fibrin formation to prevent the tumor spreading. The successfully induced inflammatory response by minocycline is supposed to prohibit the tumor invasion and metastasis. Further studies are warranted to clarify the mechanism and provide opportunities to develop novel therapeutic strategies.

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KW - intrapleural urokinase

KW - malignant pleural effusion

KW - pleurodesis

KW - survival

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