Intrapleural cisplatin and OK432 therapy for malignant pleural effusion caused by non-small cell lung cancer.
OBJECTIVE
To evaluate the efficacy of combined intrapleural therapy with cisplatin, an antineoplastic agent, and OK432, a sclerosing agent, in controlling malignant pleural effusions, when compared with monotherapy with either agent.


METHODS
A total of 49 non-small cell lung cancer patients with malignant pleural effusion were randomly assigned to one of three groups: intrapleural cisplatin therapy (n = 17), intrapleural OK432 therapy (n = 17), or both (n = 15). They were compared in terms of success rate, duration of indwelling chest tube and adverse reactions.


RESULTS
Rates of pleural effusion recurrence within 180 days following cisplatin, OK432, or combination therapy were 64.7%, 52.9% and 13.3%, respectively, being significantly lower in the combination therapy group (P = 0.01). The mean duration of chest tube drainage was 8.4 days, 5.5 days and 12.9 days, respectively, being significantly longer in the combination therapy group (P < 0.001). All procedures were well tolerated.


CONCLUSIONS
Although chest tube drainage took longer because of the time required for multiple administration of the agents, intrapleural combination therapy with cisplatin and OK432 was more effective in controlling malignant pleural effusions due to non-small cell lung cancer than monotherapy with either agent.
Ishida
Atsuko
A
Department of Pulmonary Medicine, Hiroshima City Hospital, Japan.
Miyazawa
Teruomi
T
Miyazu
Yuka
Y
Iwamoto
Yasuo
Y
Zaima
Mika
M
Kanoh
Koji
K
Sumiyoshi
Hidetaka
H
Doi
Masao
M
D000368:Aged; D000704:Analysis of Variance; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy*; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010844:Picibanil / Q000008:administration & dosage / Q000009:adverse effects; D016066:Pleural Effusion, Malignant / Q000188:drug therapy*; D011446:Prospective Studies; D016019:Survival Analysis
D010844:Picibanil; D002945:Cisplatin