title: Intrapleural chemotherapy with cisplatin and cytarabine in the management of malignant pleural effusion.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the efficacy of intrapleural chemotherapy (IPC) with cisplatin and cytarabine in the management of malignant pleural effusion (MPE) from non-small-cell lung cancer (NSCLC).
  
  
  METHODS
  A prospective analysis was carried out on 40 patients with pathologically proven MPE from NSCLC who had received IPC. A single dose of cisplatin 100 mg/m(2) plus cytarabine 1200 mg/m(2) in 250 ml normal saline was instilled into the pleural space via a chest tube and drained 4 hours later. Patients were evaluated for toxicities and responses at 1, 2, & 3 weeks and then at monthly intervals if possible. Systemic chemotherapy was administered, if the patient agreed to receive it, after achieving complete control (CC) of MPE.
  
  
  RESULTS
  The median duration of chest tube insertion for drainage was 7 (3 approximately 32) days. Among the assessable 37 patients, CC and partial control (PC) were 32 (86.5%) and 4 (10.8%) patients, respectively (overall response rate 97.3%). The median duration of response was 12 months (2 approximately 23) and there were only two relapses of IPC after achieving CC. Among the 35 patients who were assessable until they died, 28 patients (80.0%) maintained CC until the last follow-up. There was only one toxic death and the toxicities of IPC, versus the results obtained, were deemed acceptable.
  
  
  CONCLUSIONS
  The procedures were tolerable to the patients and chemotherapy-induced complications were at an acceptable level. The outcome of this trial indicates that IPC has a superior and long lasting treatment response in the management of patients with MPE from NSCLC.
authors.affiliation: Department of Internal Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, Korea.
authors.forename: Kee Won
authors.initials: KW
authors.lastname: Kim
authors.forename: Suk Young
authors.initials: SY
authors.lastname: Park
authors.forename: Myung Sook
authors.initials: MS
authors.lastname: Kim
authors.forename: Seok Chan
authors.initials: SC
authors.lastname: Kim
authors.forename: Eun Hee
authors.initials: EH
authors.lastname: Lee
authors.forename: So Young
authors.initials: SY
authors.lastname: Shin
authors.forename: Jong Ho
authors.initials: JH
authors.lastname: Lee
authors.forename: Jong Bum
authors.initials: JB
authors.lastname: Kweon
authors.forename: Kuhn
authors.initials: K
authors.lastname: Park
references.citation: Scand J Infect Dis Suppl. 1988;53:29-34
references.pmid: 3166542
references.citation: J Clin Oncol. 1991 Feb;9(2):313-9
references.pmid: 1988578
references.citation: Respir Med. 1998 Mar;92(3):473-9
references.pmid: 9692108
references.citation: Cancer. 1987 Jun 1;59(11):1973-7
references.pmid: 2436744
references.citation: Ann Intern Med. 1994 Jan 1;120(1):56-64
references.pmid: 8250457
references.citation: Chest. 1994 Dec;106(6 Suppl):363S-366S
references.pmid: 7988265
references.citation: South Med J. 1972 Jul;65(7):847-9
references.pmid: 5038178
references.citation: Semin Oncol. 1991 Feb;18(1 Suppl 2):59-61
references.pmid: 1704153
references.citation: J Chemother. 1997 Apr;9(2):106-11
references.pmid: 9176748
references.citation: Acta Oncol. 1994;33(2):191-4
references.pmid: 8204275
references.citation: Med Pediatr Oncol. 1985;13(4):191-3
references.pmid: 4040205
references.citation: Semin Oncol. 1985 Mar;12(1):54-75
references.pmid: 2579439
references.citation: Cancer. 1976 Nov;38(5):1903-8
references.pmid: 62609
references.citation: Eur J Respir Dis. 1986 Sep;69(3):204-6
references.pmid: 2430825
references.citation: Semin Oncol. 1988 Jun;15(3 Suppl 3):24-8
references.pmid: 3293215
references.citation: J Thorac Cardiovasc Surg. 1993 Apr;105(4):743-7; discussion 747-8
references.pmid: 7682268