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Cited by 578Pleural and Pulmonary DiseasesLung Cancer Diagnosis and TreatmentPericarditis and Cardiac Tamponade

Phase III intergroup study of talc poudrage vs talc slurry sclerosis for malignant pleural effusion

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Dresler, Carolyn M, Olak, Jemi, Herndon, James E, Richards, William G, Scalzetti, Ernest, Fleishman, Stewart B, Kernstine, Kemp H, Demmy, Todd +5 more·2005·Chest
DOI 10.1378/chest.127.3.909PMC PMC4644736
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Abstract

Study objective To demonstrate the efficacy, safety, and appropriate mode of instillation of talc for sclerosis in treatment of malignant pleural effusions (MPEs).Design A prospective, randomized trial was designed to compare thoracoscopy with talc insufflation (TTI) to thoracostomy and talc slurry (TS) for patients with documented MPE.Measurements The primary end point was 30-day freedom from radiographic MPE recurrence among surviving patients whose lungs initially re-expanded > 90%. Morbidity, mortality, and quality of life were also assessed.Results Of 501 patients registered, those eligible were randomized to TTI (n = 242) or TS (n = 240). Patient demographics and primary malignancies were similar between study arms. Overall, there was no difference between study arms in the percentage of patients with successful 30-day outcomes (TTI, 78%; TS, 71%). However, the subgroup of patients with primary lung or breast cancer had higher success with TTI than with TS (82% vs 67%). Common morbidity included fever, dyspnea, and pain. Treatment-related mortality occurred in nine TTI patients and seven TS patients. Respiratory complications were more common following TTI than TS (14% vs 6%). Respiratory failure was observed in 4% of TS patients and 8% of TTI patients, accounting for five toxic deaths and six toxic deaths, respectively. Quality-of-life measurement demonstrated less fatigue with TTI than TS. Patient ratings of comfort and safety were also higher for TTI, but there were no differences on perceived value or convenience of the procedures.Conclusions Both methods of talc delivery are similar in efficacy; TTI may be better for patients with either a lung or breast primary. The etiology and incidence of respiratory complications from talc need further exploration.

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  1. [12]Fleishman SB, Dresler C, Herndon JE, et al. Quality of life (QOL) advantage of sclerosis for malignant pleural effusion (MPE) via talc thoracoscopy over chest tube infusion of talc slurry: a Cancer and Leukemia Group B study [abstract] Proc Am Soc Clin Oncol. 2002;21:355a. [Google Scholar]
  2. [14]Common toxicity criteria, version 2.0. Bethesda, MD: National Cancer Institute; 1999. [PubMed] [Google Scholar]

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Authors
Dresler, C. M., Olak, J., Herndon, J. E., Richards, W. G., Scalzetti, E., Fleishman, S. B., Kernstine, K. H., Demmy, T., Jablons, D. M., Kohman, L., Daniel, T. M., Haasler, G. B., & Sugarbaker, D. J.
Affiliations
  • Centre international de recherche sur le cancer (FR)
  • Advocate Lutheran General Hospital (US)
  • Brigham and Women's Hospital (US)
  • SUNY Upstate Medical University (US)
  • University of Iowa (US)
  • Roswell Park Comprehensive Cancer Center (US)
  • University of California, San Francisco (US)
  • University of Virginia Health System (US)
  • Medical College of Wisconsin (US)
Corresponding author
Dresler, Carolyn M
ORCID
Venue
Chest
Publisher
Elsevier BV
Published
2005-03
Volume
127
Issue
3
Pages
909-915
ISSN
0012-3692 (ISSN-L)
DOI
10.1378/chest.127.3.909
PMC
PMC4644736
OpenAlex
W2147481343
Cited by
578
References
39
Citations by year
2026: 10 · 2025: 20 · 2024: 24 · 2023: 12 · 2022: 27 · 2021: 26 · 2020: 40 · 2019: 23 · 2018: 38 · 2017: 31 · 2016: 32 · 2015: 34 · 2014: 32 · 2013: 33 · 2012: 35
FWCI
22.73
Type
journal article
Language
en
Open access
Licence
Locations
  • CHEST Journal (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Cancer Institute (2 U01 CA65170, R01CA093708, U01CA065170)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Pleural and Pulmonary Diseases
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Diagnosis and Treatment
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Pericarditis and Cardiac Tamponade
Keywords
malignant pleural effusion, talc poudrage, talc slurry, talc pleurodesis, thoracostomy, pleural effusion recurrence, respiratory complications, non-relapse mortality, quality of life, lung cancer, breast cancer
MeSH terms
Adult, Aged, Aged, 80 and over, Female, Humans, Insufflation, Male, Middle Aged, Quality of Life, Recurrence, Talc, Thoracoscopy, Thoracostomy, Pleural Effusion, Malignant, Pleurodesis

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