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Talc pleurodesis

Hideo Saka, Masahide Oki, Chiyoe Kitagawa, Yoshihito Kogure, Yuki Kojima, Akiko M Saito, Atsuko Ishida, Teruomi Miyazawa, Koji Takeda, Kazuhiko Nakagawa, Shinji Sasada, Shunichi Negoro
Background: Malignant pleural effusion is a commonly seen complication of malignancies such as lung and breast cancers. In Western countries, talc is frequently used as a standard therapeutic agent (pleurodesis agent) with the aim of alleviating symptoms including dyspnea and chest pain. Talc is not recognized as a pleurodesis agent in Japan. The aim of this study was to verify the efficacy and safety of sterilized talc (NPC-05) for the introduction of talc in Japan. Methods: The study was a single-arm, open-label, investigator-initiated trial conducted jointly at six institutions...
March 8, 2018: Japanese Journal of Clinical Oncology
Rachelle Asciak, Najib M Rahman
Malignant pleural effusion is a common complication of cancer and denotes a poor prognosis. It usually presents with dyspnea and a unilateral large pleural effusion. Thoracic computed tomography scans and ultrasound are helpful in distinguishing malignant from benign effusions. Pleural fluid cytology is diagnostic in about 60% of cases. In cytology-negative disease, pleural biopsies are helpful. Current management is palliative. Previously, first-line treatment for recurrent symptomatic malignant pleural effusion was chest drain insertion and talc pleurodesis, with indwelling pleural catheter insertion reserved for patients with trapped lung or failed talc pleurodesis...
March 2018: Clinics in Chest Medicine
Jacopo Vannucci, Guido Bellezza, Alberto Matricardi, Giulia Moretti, Antonello Bufalari, Lucio Cagini, Francesco Puma, Niccolò Daddi
Talc pleurodesis has been associated with pleuropulmonary damage, particularly long-term damage due to its inert nature. The present model series review aimed to assess the safety of this procedure by examining inflammatory stimulus, biocompatibility and tissue reaction following talc pleurodesis. Talc slurry was performed in rabbits: 200 mg/kg checked at postoperative day 14 (five models), 200 mg/kg checked at postoperative day 28 (five models), 40 mg/kg, checked at postoperative day 14 (five models), 40 mg/kg checked at postoperative day 28 (five models)...
January 2018: Experimental and Therapeutic Medicine
Elena Arellano-Orden, Beatriz Romero-Romero, Verónica Sánchez-López, José Martín-Juan, Francisco Rodríguez-Panadero, Remedios Otero-Candelera
BACKGROUND: Survivin is a well-known member of the inhibitor of apoptosis family, and has been related to increased tumour aggressivity, both in tissue and in pleural fluid. OBJECTIVES: In patients with malignant pleural effusion, we sought to investigate the changes in pleural fluid survivin concentrations induced by talc instillation into the pleural space. Those changes were also examined in relation to pleurodesis outcome and patient survival. METHODS: We investigated 84 patients with malignant pleural effusion who underwent talc pleurodesis...
January 23, 2018: European Journal of Clinical Investigation
Joke Leemans, Christophe Dooms, Vincent Ninane, Jonas Yserbyt
BACKGROUND AND OBJECTIVE: Malignant pleurisy is associated with advanced oncological disease and dyspnoea is the most common presenting symptom. Pleurodesis is the preferred palliative and supportive treatment option, targeting symptom relief. The identification of clinical and endoscopic features that determine the success of talc pleurodesis in malignant pleurisy could guide clinical decision-making. METHODS: All symptomatic patients with malignant pleurisy subjected to talc pleurodesis through medical thoracoscopy between January 2012 and December 2015 were included...
January 10, 2018: Respirology: Official Journal of the Asian Pacific Society of Respirology
Emanuela Taioli, Maaike van Gerwen, Meredith Mihalopoulos, Gil Moskowitz, Bian Liu, Raja Flores
Malignant pleural mesothelioma (MPM) is an aggressive tumor and the prognosis is still dismal despite the various proposed multimodal treatment plans. Currently, new palliative treatments, such as talc pleurodesis, are being explored besides traditional surgery. This review reports survival rates after talc pleurodesis in comparison to surgery in patients with malignant pleural mesothelioma. A systematic literature search yielded 49 articles eligible for this review. The mean survival in the talc pleurodesis group was 14 months compared to 17 and 24 months for the pleurectomy decortication (P/D) group and extrapleural pneumonectomy (EPP) group, respectively...
December 2017: Journal of Thoracic Disease
Christopher R Gilbert, Benjamin R Furman, David J Feller-Kopman, Philippe Haouzi
BACKGROUND: Widespread use of talc pleurodesis remains controversial for many providers concerned by adverse events such as respiratory failure, which are sometimes fatal. Particle talc size has been implicated in these adverse effects, mainly on the basis of animal studies utilizing large amounts of talc or in observational studies performed on different continents with different talc preparations and doses. Our aim was to determine the particle size and distribution of only the commercially available US-talc preparations and whether the fluid content can affect this distribution...
January 2018: Journal of Bronchology & Interventional Pulmonology
Ioannis Psallidas, Hania E G Piotrowska, Ahmed Yousuf, Nikolaos I Kanellakis, Gayathri Kagithala, Seid Mohammed, Lei Clifton, John P Corcoran, Nicky Russell, Melissa Dobson, Robert F Miller, Najib M Rahman
Introduction: Malignant pleural effusion (MPE) is common and currently in UK there are an estimated 50 000 new cases of MPE per year. Talc pleurodesis remains one of the most popular methods for fluid control. The value of thoracic ultrasound (TUS) imaging, before and after pleurodesis, in improving the quality and efficacy of care for patients with MPE remains unknown. Additionally, biomarkers of successful pleurodesis including measurement of pleural fluid proteins have not been validated in prospective studies...
2017: BMJ Open Respiratory Research
Ivo Figueiredo, Anilsa Cossa, Anila Hassane, José Sousa, Joaquim Pondo, João Teixeira, Kevan Akrami, Susannah K Graves, Atul Malhotra, Elizabete A Nunes
Background: Pleural effusions constitute one of the most frequent pathologies encountered in the pulmonary service of Maputo Central Hospital (MCH) in Mozambique. Bleomycin and talc are commonly used for pleurodesis, but cost prohibitive, therefore we aimed to retrospectively compare the efficacy and safety of sodium hydroxide (NaOH) with bleomycin for pleurodesis. Methods: Case records of pleurodesis using bleomycin and NaOH from 2002 to 2013 were reviewed. Standard of care for pleurodesis for recurrent pleural effusions at MCH was developed using the materials available...
September 2017: Journal of Thoracic Disease
Rajesh Thomas, Edward T H Fysh, Nicola A Smith, Pyng Lee, Benjamin C H Kwan, Elaine Yap, Fiona C Horwood, Francesco Piccolo, David C L Lam, Luke A Garske, Ranjan Shrestha, Christopher Kosky, Catherine A Read, Kevin Murray, Y C Gary Lee
Importance: Indwelling pleural catheter and talc pleurodesis are established treatments for malignant pleural effusions among patients with poor prognosis. Objective: To determine whether indwelling pleural catheters are more effective than talc pleurodesis in reducing total hospitalization days in the remaining lifespan of patients with malignant pleural effusion. Design, Setting, and Participants: This open-label, randomized clinical trial included participants recruited from 9 centers in Australia, New Zealand, Singapore, and Hong Kong between July 2012 and October 2014; they were followed up for 12 months (study end date: October 16, 2015)...
November 21, 2017: JAMA: the Journal of the American Medical Association
Jung Seop Eom, Hyo Yeong Ahn, Jeong Ha Mok, Geewon Lee, Eun-Jung Jo, Mi-Hyun Kim, Kwangha Lee, Ki Uk Kim, Hye-Kyung Park, Min Ki Lee
BACKGROUND: Talc poudrage during thoracoscopy is considered the standard procedure for patients with symptomatic malignant pleural effusion (MPE). Until now, no alternative technique other than talc poudrage for pleurodesis during medical thoracoscopy has been proposed. Liquid sclerosants, such as mistletoe extract, have been sprayed evenly into the pleural cavity during semirigid pleuroscopy for chemical pleurodesis. OBJECTIVE: We conducted a retrospective study using the database of semirigid pleuroscopy to identify the usefulness of pleurodesis using a mistletoe extract delivered via a spray catheter during semirigid pleuroscopy for symptomatic MPE...
November 7, 2017: Respiration; International Review of Thoracic Diseases
Yusuke Kakiuchi, Fumihiro Yamaguchi, Makoto Hayashi, Yusuke Shikama
The purpose of this article is to report a case of hemoptysis occurring in combination with secondary spontaneous pneumothorax following chemical pleurodesis by talc. A Japanese male with cancer of renal pelvis was found with the left pneumothorax and multiple lung metastases. A computed-tomography scan revealed severe emphysema throughout the lungs. Talc pleurodesis was employed to arrest air leakage. The patient developed hemoptysis 45 minutes after talc injection into the thorax. This is the first report of hemoptysis following talc pleurodesis...
2017: Case Reports in Pulmonology
Deirdre B Fitzgerald, Coenraad F N Koegelenberg, Kazuhiro Yasufuku, Y C Gary Lee
Optimal management of malignant pleural effusion (MPE) is important in the care of patients with advanced cancer. Surgical (especially video-assisted thoracoscopic surgery (VATS)) and non-surgical strategies are available. Clinicians should be aware of the evidence supporting the use of different modalities to guide treatment choice. Areas covered: This review covers published evidence of the advantages and disadvantages of VATS and non-surgical alternatives for MPE management. Expert commentary: Randomized clinical trials (RCTs) are needed to define the roles and benefits of VATS as existing literature is often flawed by selection bias...
January 2018: Expert Review of Respiratory Medicine
Rajany Dy, Sumit Patel, Pichapong Tunsupon, M Jeffery Mador
No abstract text is available yet for this article.
2017: Ochsner Journal
Emi Date, Kunio Okamoto, Souichi Fumita, Hiroyasu Kaneda
Lenvatinib, a novel potent multikinase inhibitor, was approved for the treatment of radioiodine-refractory differentiated thyroid cancer based on results from phase III trial (SELECT study). Thyroid cancer is a diverse disease that includes anaplastic thyroid cancer (ATC), which the most aggressive form of the disease, although it accounts for <2% of all thyroid cancers. Current treatments for ATC have limited efficacy. We report the case of a woman with recurrent well-differentiated papillary carcinoma of the thyroid that had transformed into ATC who developed a perforation of the small intestine secondary to a marked effect of lenvatinib...
October 11, 2017: Investigational New Drugs
Yuki Shinno, Hidenori Kage, Haruka Chino, Atsushi Inaba, Sayaka Arakawa, Satoshi Noguchi, Yosuke Amano, Yasuhiro Yamauchi, Goh Tanaka, Takahide Nagase
BACKGROUND AND OBJECTIVE: Talc pleurodesis is commonly performed to manage refractory pleural effusion or pneumothorax. It is considered as a safe procedure as long as a limited amount of large particle size talc is used. However, acute respiratory distress syndrome (ARDS) is a rare but serious complication after talc pleurodesis. We sought to determine the risk factors for the development of ARDS after pleurodesis using a limited amount of large particle size talc. METHODS: We retrospectively reviewed patients who underwent pleurodesis with talc or OK-432 at the University of Tokyo Hospital...
January 2018: Respirology: Official Journal of the Asian Pacific Society of Respirology
Sara Colella, Federica Fioretti, Chiara Massaccesi, Gian L Primomo, Gianluca Panella, Vittorio D'Emilio, Riccardo Pela
INTRODUCTION: Although pleural effusion (PE) can be caused by several pathologies like congestive heart failure, infections, malignancies, and pulmonary embolism, it is also a common finding in chronic kidney disease (CKD). Diagnostic thoracentesis is of limited value in the differential diagnosis, and the role of more invasive investigations like medical thoracoscopy (MT) is still unclear. AIM: To evaluate the usefulness of MT in unexplained PE in CKD. MATERIALS AND METHODS: In the electronic database of our Institution, we retrospectively searched for patients with CKD who underwent MT for unexplained PE between January 2008 and August 2016...
October 2017: Journal of Bronchology & Interventional Pulmonology
Paolo Andrea Zucali, Egesta Lopci, Giovanni Luca Ceresoli, Laura Giordano, Matteo Perrino, Gianluigi Ciocia, Letizia Gianoncelli, Elena Lorenzi, Matteo Simonelli, Fabio De Vincenzo, Lucia Rebecca Setti, Cristiana Bonifacio, Maria Bonomi, Emilio Bombardieri, Arturo Chiti, Armando Santoro
The aim of this study was to evaluate the role of metabolic parameters analyzed at baseline and at interim FDG-PET in predicting disease outcome in unresectable MPM patients receiving pemetrexed-based chemotherapy. A consecutive series of MPM patients treated between February 2004 and July 2013 with first-line pemetrexed-based chemotherapy, and evaluated by FDG-PET and CT scan at baseline and after two cycles of chemotherapy, was reviewed. Best CT scan response was assessed according to modified RECIST criteria...
October 2017: Cancer Medicine
Alfonso Fiorelli, Francesco Caronia, Aldo Prencipe, Mario Santini, Brendon Stiles
A best evidence topic in thoracic surgery was written addressing whether video-assisted thoracoscopic surgery (VATS) talc pleurodesis could be justified in patients with pleural effusion (PE) after coronary artery bypass graft (CABG) surgery and no-responded to repeated thoracentesis. Ten papers were identified to answer the question. Of these, two were case-series study including ≥4 patients, 7 retrospective analytical studies, and one observational study but no randomized controlled trial (RCTs) was included in the analysis...
August 2017: Journal of Thoracic Disease
Aldo Pezzuto, Fabrizio Terzo, Maria Laura Graziani, Alberto Ricci, Pierdonato Bruno, Salvatore Mariotta
The present study reports two cases of lung cancer with the involvement of the pleura. The diagnosis of adenocarcinoma with epidermal growth factor receptor (EGFR) mutation was made following repeated thoracentesis with cytology of pleural fluid and thoracoscopy with pleural biopsies. Talc pleurodesis was successfully performed in both cases subsequent to diagnosis. Following talc pleurodesis, the first patient (62 years old; male; non-smoker) underwent 3 cycles of cisplatin/vinorelbine chemotherapy, with a poor response...
September 2017: Oncology Letters
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