Malignant Pleural Effusions—Personalised Management

被引：1

作者：

Ahmed M. ^{[1
]}

Wrightson J.M. ^{[2
]}

机构：

[1] Interventional Respiratory Unit, Galway University Hospital, Newcastle Road, Galway

[2] Oxford Centre for Respiratory Medicine, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford

来源：

Current Geriatrics Reports | 2018年 / 7卷 / 3期

关键词：

Chest drain; Indwelling pleural catheter; Lung cancer; Pleural effusion; Pleurodesis;

D O I：

10.1007/s13670-018-0246-0

中图分类号：

学科分类号：

摘要：

Purpose of Review: Malignant pleural effusions (MPEs) are frequent and are associated with significant morbidity and mortality. This article reviews the most recent literature on the management of MPE. Recent Findings: With an increasing focus on personalised medicine, the primary treatment aims have changed from the primary aim of recurrence prevention to symptom control and quality of life improvement. Dependent on patient preference, options available to achieve such targets include repeated aspiration, talc pleurodesis (either through a small-bore chest drain or at thoracoscopy), and indwelling pleural catheters (IPCs). There is a consensus regarding the use of IPC in cases of trapped lung and failed talc pleurodesis, but two recent randomised controlled trials have proposed the use of IPCs as first-line therapy. Conclusion: MPE management should be personalised, considering factors such as predicted survival, performance status, social support, local expertise and, most importantly, patient preference. IPCs are now more widely available as a treatment option and should be explored as a first-line treatment in selected patients. © 2018, Springer Science+Business Media, LLC, part of Springer Nature.

引用

页码：154 / 159

页数：5

共 35 条

[1]

Gurung P., Goldblatt M.R., Huggins J.T., Doelken P., Sahn S.A., Pleural fluid characteristics of paramalignant effusion, Chest, 136, 4, (2009)

[2]

Hsu C., Cytologic detection of malignancy in pleural effusion: a review of 5,255 samples from 3,811 patients, Diagn Cytopathol, 3, 1, pp. 8-12, (1987)

[3]

Johnston W.W., The malignant pleural effusion. A review of cytopathologic diagnoses of 584 specimens from 472 consecutive patients, Cancer, 56, 4, pp. 905-909, (1985)

[4]

Roberts M.E., Neville E., Berrisford R.G., Antunes G., Ali N.J., Management of a malignant pleural effusion: British Thoracic Society pleural disease guideline 2010, Thorax, 65, pp. ii32-ii40, (2010)

[5]

Marosi C., Koller M., Challenge of cancer in the elderly, ESMO Open, 1, 3, (2016)

[6]

Schiphorst A.H.W., Ten Bokkel Huinink D., Breumelhof R., Jpj B., Pronk A., Hamaker M., Geriatric consultation can aid in complex treatment decisions for elderly cancer patients, Eur J Cancer Care (Engl), 25, 3, pp. 365-370, (2016)

[7]

Taghizadeh N., Fortin M., Tremblay A.U.S., Hospitalizations for malignant pleural effusions: data from the 2012 national inpatient sample, Chest, 151, 4, pp. 845-854, (2017)

[8]

Clive A.O., Kahan B.C., Hooper C.E., Bhatnagar R., Morley A.J., Zahan-Evans N., Bintcliffe O.J., Boshuizen R.C., Fysh E.T.H., Tobin C.L., Medford A.R.L., Harvey J.E., van den Heuvel M.M., Lee Y.C.G., Maskell N.A., Predicting survival in malignant pleural effusion: development and validation of the LENT prognostic score, Thorax, 69, 12, pp. 1098-1104, (2014)

[9]

Clive A.O., Jones H.E., Bhatnagar R., Preston N.J., Maskell N., Interventions for the management of malignant pleural effusions: a network meta-analysis, Cochrane Database Syst Rev, 5, (2016)

[10]

Diacon A.H., Wyser C., Bolliger C.T., Tamm M., Pless M., Perruchoud A.P., Et al., Prospective randomized comparison of thoracoscopic talc poudrage under local anesthesia versus bleomycin instillation for pleurodesis in malignant pleural effusions, Am J Respir Crit Care Med, 162, 4, pp. 1445-1449, (2000)

← 1 2 3 4 →