恶性胸腔积液(MPE)是晚期癌症中常见的一种使人衰弱的疾病,预期寿命很短。症状包括疼痛和严重的呼吸急促。当前的一线治疗选择包括使用导管的胸膜引流以及胸膜固定术。然而,这些治疗方式通常效率低下,患者需要重复手术.胸内加压雾化化疗(PITAC)是一种微创手术,其中抗肿瘤剂在压力下雾化进入胸膜腔。
■我们提出了初步的安全性,可行性,以及基于综合文献综述的PITAC反应评估数据。
■五项回顾性研究报告了21例患者中38例PITAC的数据。数据在程序等几个重要方面是异构和不完整的,安全,局部效应和长期结果。PITAC在技术上似乎是可行的,并发症的风险较低,并且在某些情况下可以减少MPE。
■PITAC似乎可行,但是需要前瞻性的I期和II期研究来定义安全性,适应症,和功效。
UNASSIGNED: Malignant pleural effusion (MPE) is a common and debilitating condition seen in advanced cancer disease, and life-expectancy is short. Symptoms include pain and severe shortness of breath. Current first-line treatment options include pleural drainage using catheters as well as pleurodesis. However, these treatment modalities are often inefficient and patients need repeated procedures. Pressurized IntraThoracic Aerosol Chemotherapy (PITAC) is a minimally invasive procedure, where antineoplastic agents are nebulized under pressure into the pleural space.
UNASSIGNED: We present the preliminary safety, feasibility, and response assessment data for PITAC based on a comprehensive literature review.
UNASSIGNED: Five retrospective studies reported data on 38 PITACs in 21 patients. Data were heterogeneous and incomplete on several important aspects such as procedure, safety, local effect and long-term outcomes. PITAC seems technically feasible with a low risk of complications and may provide some reduction in MPE in selected cases.
UNASSIGNED: PITAC seems feasible, but prospective phase I and II studies are needed to define safety, indications, and efficacy.