Combined intrapleural and intravenous chemotherapy, and pulmonary irradiation, for treatment of patients with lung cancer presenting with malignant pleural effusion: A pilot study

Wu Chou Su, Wu Wei Lai, Helen H.W. Chen, Tzuen Ren Hsiue, Cheng Wen Chen, Wen Tsung Huang, Tsai Yun Chen, Chao Jung Tsao, Nai San Wang

Research output: Contribution to journalArticlepeer-review

28 Citations (Scopus)

Abstract

Objectives: Patients with non-small-cell lung cancer (NSCLC) and malignant pleural effusion (MPE) are difficult to manage clinically and have a short life expectancy. In this pilot study, we designed a protocol of combined intrapleural (i.p.) and intravenous (i.v.) chemotherapy and pulmonary irradiation to enhance local as well as systemic control of the disease. Methods: From April 1998 to April 2000, 27 patients with NSCLC and symptomatic MPE were eligible for the study. Patients received pre-radiation chemotherapy (cisplatin 60 mg/m2 i.p. on day 1; gemcitabine 1,000 mg/m2 i.v. on days 1, 8, and 15, q4week × 3) after surgical implantation of i.p. and i.v. port-A, followed by radiotherapy (7,020 cGy/39fr), and, finally, post-radiation chemotherapy (docetaxel 60 mg/m2 q3week × 3-6 i.v.). Results: Grade 1/2 nausea/vomiting and impaired renal function were more common from pre-radiation than post-radiation chemotherapy; however, grade 3/4 toxicities from pre-radiation chemotherapy were minimal. Conversely, grade 3/4 leukopenia and grade 1/2 alopecia, diarrhea, elevation of SGOT/SGPT, and sensory impairment were more common following post-radiation chemotherapy. Only two patients experienced recurrence of pleural effusion. The overall response rate was 55% with 7% complete remission, 48% partial remission, 22% stable disease, and 22% progressive disease. The median failure-free and overall survival was 8 and 16 months, respectively. The one-year survival rate was 63% (95% confidence interval, 45-80%). Conclusions: We conclude that the combination of i.p. and i.v. chemotherapy and pulmonary irradiation is feasible and should be tested in a larger clinical trial to determine whether survival can be improved for this cohort of patients.

Original languageEnglish
Pages (from-to)18-24
Number of pages7
JournalOncology
Volume64
Issue number1
DOIs
Publication statusPublished - 2003

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

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