A case of successful intrapleural chemotherapy with Cisplatin plus cytarabine for intractable malignant pleural effusion.
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.
Moon
Yong Wha
YW
Yonsei Cancer Center, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Choi
Sang Tae
ST
Cho
Byoung Chul
BC
Choi
Hye Jin
HJ
Kim
Yong Tai
YT
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
D003561:Cytarabine; D002945:Cisplatin