title: A case of successful intrapleural chemotherapy with Cisplatin plus cytarabine for intractable malignant pleural effusion.
abstract: When conventional treatments of malignant pleural effusion, such as repeated thoracentesis, closed thoracotomy and pleurodesis by instilled sclerosing agents, are ineffective, there are few alternative therapies available. Our case involves a 47-year-old woman with uterine cervical carcinoma suffering from malignant pleural effusion. She presented with a chief complaint of severe dyspnea, and was classified as an Eastern Cooperative Oncology Group (ECOG) performance status of 4. Her underlying cervical carcinoma progressed despite various systemic chemotherapy regimens. In addition, pleural effusion persisted in spite of 4 weeks of drainage through the thoracotomy tube and talc pleurodesis. Under such circumstances, we attempted intrapleural chemotherapy with cisplatin plus cytarabine, which resulted in significant decrease of the pleural effusion. No serious systemic toxicities, including myelosuppression, were observed. As a result, the patient's dyspnea was relieved, and her ECOG performance status improved from 4 to 2. However, the thoracotomy tube was not removed due to subsequent iatrogenic pneumothorax. Pleural effusion did not recur for the 4 weeks leading up to her death.
authors.affiliation: Yonsei Cancer Center, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Yong Wha
authors.initials: YW
authors.lastname: Moon
authors.forename: Sang Tae
authors.initials: ST
authors.lastname: Choi
authors.forename: Byoung Chul
authors.initials: BC
authors.lastname: Cho
authors.forename: Hye Jin
authors.initials: HJ
authors.lastname: Choi
authors.forename: Yong Tai
authors.initials: YT
authors.lastname: Kim
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D003561:Cytarabine / Q000008:administration & dosage; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008875:Middle Aged; D016066:Pleural Effusion, Malignant / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D003561:Cytarabine; D002945:Cisplatin