[Locoregional therapy in patients with malignant pleural effusion--two different types of "BAC therapy"].
We used fibrin clot (FC) as a carrier of anticancer drug (AD) to provide a novel therapy for patients with serious malignant pleural effusion. After evacuating the pleural fluid, we enhanced an "FC-AD" formation in the pleural cavity of the patient to prevent this kind of effusion from reaccumulating. In an attempt to enhance FC-AD formation, we used two different procedures; either, fibrinogen/AD/G.T.XIII (procedure I) or fibrin glue/AD (procedure II). G.T.XIII is our newly devised compound drug, composed of biodegradable gelatin (G), thrombin (T) and a blood coagulation factor XIII (XIII). This therapy was termed "Bio-Adhesio-Chemo (BAC) therapy." We conducted BAC therapy 52 times on 44 patients using procedure I and 4 times on 4 patients using procedure II. Complete remission of the effusion was obtained, overall, in 83%, partial remission in 17%, and no non-effective case. The improvement of PS of the patients treated was 73%. Nineteen patients could be discharged with this therapy. Toxic effects with BAC therapy were within Grade 2 in all cases. We could favorably enhance FC-AD formation, in every case, by both procedure I and II. BAC therapy is very promising as a novel cancer chemopleurodesis for patients with malignant pleural effusion.
Sugitachi
A
A
Dept. of Surgery, Osaka National Hospital.
Kawahara
T
T
Kido
T
T
Shindoh
T
T
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage*; D004317:Doxorubicin / Q000008:administration & dosage*; D004322:Drainage / Q000379:methods; D016503:Drug Delivery Systems; D005176:Factor XIII / Q000008:administration & dosage; D015718:Fibrin Tissue Adhesive / Q000008:administration & dosage; D005340:Fibrinogen / Q000008:administration & dosage*; D006801:Humans; D009369:Neoplasms / Q000150:complications*; D010996:Pleural Effusion / Q000628:therapy*; D013917:Thrombin
D015718:Fibrin Tissue Adhesive; D004317:Doxorubicin; D005340:Fibrinogen; D005176:Factor XIII; D013917:Thrombin; D002945:Cisplatin