A propensity score-matched comparison of the efficacies of OK-432 and talc slurry for pleurodesis for malignant pleural effusion induced by lung adenocarcinoma

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• 作者：Kango Nohara ; M.D. ^{kango19841204@outlook.jp" class="auth_mail" title="E-mail the corresponding author} ; Kazuto Takada ; M.D. ; Ph.D. ; ^{k-takada@komakihp.gr.jp" class="auth_mail" title="E-mail the corresponding author} ; Eiji Kojima ; M.D. ; Ph.D. ^{e-kojima@komakihp.gr.jp" class="auth_mail" title="E-mail the corresponding author} ; Kiyoko Ninomiya ; M.D. ^{nino-kiyo@komakihp.gr.jp" class="auth_mail" title="E-mail the corresponding author} ; Shoko Miyamatsu ; M.D. ^{shoko.miyamatsu@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Takahiro Shimizu ; M.D. ^{shimi-taka@komakihp.gr.jp" class="auth_mail" title="E-mail the corresponding author} ; Tsutomu Sakurai ; M.D. ^{tsakura390@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Takaaki Mizuno ; M.D. ^{straight.822@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Yuuki Yamashita ; M.D. ^{a6mb1095@icloud.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：IPC ; indwelling pleural catheter ; MPE ; malignant pleural effusion ; Talc-s ; talc slurry.
• 刊名：Respiratory Investigation
• 出版年：2016
• 出版时间：September 2016
• 年：2016
• 卷：54
• 期：5
• 页码：341-346
• 全文大小：508 K

文摘

The choice of an optimal sclerosant for pleurodesis for malignant pleural effusion remains controversial. This retrospective clinical study compared the efficacy and safety of two sclerosants; talc slurry (talc-s) and OK-432.

Methods

We compared the characteristics, 30/90-day success rates, and adverse events in patients with lung adenocarcinoma who underwent pleurodesis by using either OK-432 or talc-s. Propensity score matching was used to compare the two scelrosants.

Results

Ninety-four patients (mean age=71.6±9.6 years) were included in this retrospective study, of whom 64 received OK-432 and 30 received talc-s. Seventy-three patients (77.6%) were initially diagnosed with clinical stage IV lung cancer, with a 28.7% epidermal growth factor receptor mutation frequency. The propensity score-matched cohort included 26 patients from each group. The 30-day success rates for OK-432 and talc-s were 80.7% and 76.9%, respectively (odds ratio: 1.26, 95% confidence interval: 0.33–4.77, p=0.73). Neither the overall incidence of adverse events nor the 90-day success rates differed significantly. Multivariate logistic regression revealed that the predictors of 30-day success were lower drainage volume on the previous day, particularly <250 mL/day, the presence of full lung expansion, and pre-therapy with an epidermal growth factor receptor-tyrosine kinase inhibitor. The median post-pleurodesis survival time was 6.9 months, which was not significantly different between the study groups.

Conclusions

Propensity score-matched analyses showed that pleurodesis using OK-432 and talc-s demonstrated comparable efficacy and safety profiles in patients with lung adenocarcinoma. This indicated that OK-432 could be a viable alternative to talc-s in this procedure.