Prospective Randomized Trial of Intrapleural Bleomycin Versus Interferon Alfa-2b via Ultrasound-Guided Small-Bore Chest Tube in the Palliative Treatment of Malignant Pleural Effusions
To compare bleomycin pleurodesis and immunotherapy with intrapleural interferon alfa-2b (IFN) in the palliation of malignant pleural effusions. One hundred sixty patients with rapidly recurrent malignant pleural effusion were randomly assigned to intrapleural bleomycin (83 patients) or IFN (77 patie...
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| Veröffentlicht in: | Journal of clinical oncology 2004-04, Vol.22 (7), p.1228-1233 |
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| container_title | Journal of clinical oncology |
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| creator | SARTORI, Sergio TASSINARI, Davide CECCOTTI, Piercarlo TOMBESI, Paola NIELSEN, Ingrid TREVISANI, Lucio ABBASCIANO, Vincenzo |
| description | To compare bleomycin pleurodesis and immunotherapy with intrapleural interferon alfa-2b (IFN) in the palliation of malignant pleural effusions.
One hundred sixty patients with rapidly recurrent malignant pleural effusion were randomly assigned to intrapleural bleomycin (83 patients) or IFN (77 patients). A 9-French intrapleural catheter was placed under sonographic guidance, and pleural effusion was completely drained before starting the treatment. Bleomycin 0.75 mg/kg was administered as a single dose. An additional dose was given if daily fluid output did not drop to less than 100 mL/d within 3 days. IFN 1 million units/10 kg was administered for six courses at 4-day intervals. Thirty-day and long-term responses were evaluated under the intention-to-treat principle.
Thirty-day response was 84.3% in the bleomycin arm and 62.3% in IFN arm (P =.002). Median time to progression was 93 days (range, 12 to 395 days) in bleomycin group, and 59 days (range, 7 to 292 days) in the IFN group (P |
| doi_str_mv | 10.1200/JCO.2004.09.164 |
| format | Article |
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One hundred sixty patients with rapidly recurrent malignant pleural effusion were randomly assigned to intrapleural bleomycin (83 patients) or IFN (77 patients). A 9-French intrapleural catheter was placed under sonographic guidance, and pleural effusion was completely drained before starting the treatment. Bleomycin 0.75 mg/kg was administered as a single dose. An additional dose was given if daily fluid output did not drop to less than 100 mL/d within 3 days. IFN 1 million units/10 kg was administered for six courses at 4-day intervals. Thirty-day and long-term responses were evaluated under the intention-to-treat principle.
Thirty-day response was 84.3% in the bleomycin arm and 62.3% in IFN arm (P =.002). Median time to progression was 93 days (range, 12 to 395 days) in bleomycin group, and 59 days (range, 7 to 292 days) in the IFN group (P <.001). Median survival was 96 days (range, 15 to 395) and 85 days (range, 16 to 292) in the bleomycin and IFN groups, respectively. Twenty-three patients received two doses of bleomycin, as their daily fluid output remained higher than 100 mL after the first dose. Thirteen of them had complete response, which lasted until death.
Intrapleural bleomycin is more effective than IFN and is a valid option for the palliative treatment of massive, rapidly recurrent malignant pleural effusions. The administration of a second dose of bleomycin to patients not responding to the first one can remarkably improve the overall outcome of the treatment.</description><identifier>ISSN: 0732-183X</identifier><identifier>EISSN: 1527-7755</identifier><identifier>DOI: 10.1200/JCO.2004.09.164</identifier><identifier>PMID: 15051770</identifier><language>eng</language><publisher>Baltimore, MD: American Society of Clinical Oncology</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Antineoplastic agents ; Antineoplastic Agents - administration & dosage ; Biological and medical sciences ; Bleomycin - administration & dosage ; Catheterization ; Chemotherapy ; Chest Tubes ; Female ; Humans ; Instillation, Drug ; Interferon-alpha - administration & dosage ; Male ; Medical sciences ; Middle Aged ; Palliative Care ; Pharmacology. Drug treatments ; Pleural Effusion, Malignant - diagnostic imaging ; Pleural Effusion, Malignant - drug therapy ; Pleurodesis ; Pneumology ; Prospective Studies ; Recombinant Proteins ; Treatment Outcome ; Tumors of the respiratory system and mediastinum ; Ultrasonography</subject><ispartof>Journal of clinical oncology, 2004-04, Vol.22 (7), p.1228-1233</ispartof><rights>2004 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c461t-e0b1be42467329264dd456e96703679e1914060f5a4762590cad37a719d3f5903</citedby><cites>FETCH-LOGICAL-c461t-e0b1be42467329264dd456e96703679e1914060f5a4762590cad37a719d3f5903</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,3729,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15653258$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15051770$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>SARTORI, Sergio</creatorcontrib><creatorcontrib>TASSINARI, Davide</creatorcontrib><creatorcontrib>CECCOTTI, Piercarlo</creatorcontrib><creatorcontrib>TOMBESI, Paola</creatorcontrib><creatorcontrib>NIELSEN, Ingrid</creatorcontrib><creatorcontrib>TREVISANI, Lucio</creatorcontrib><creatorcontrib>ABBASCIANO, Vincenzo</creatorcontrib><title>Prospective Randomized Trial of Intrapleural Bleomycin Versus Interferon Alfa-2b via Ultrasound-Guided Small-Bore Chest Tube in the Palliative Treatment of Malignant Pleural Effusions</title><title>Journal of clinical oncology</title><addtitle>J Clin Oncol</addtitle><description>To compare bleomycin pleurodesis and immunotherapy with intrapleural interferon alfa-2b (IFN) in the palliation of malignant pleural effusions.
One hundred sixty patients with rapidly recurrent malignant pleural effusion were randomly assigned to intrapleural bleomycin (83 patients) or IFN (77 patients). A 9-French intrapleural catheter was placed under sonographic guidance, and pleural effusion was completely drained before starting the treatment. Bleomycin 0.75 mg/kg was administered as a single dose. An additional dose was given if daily fluid output did not drop to less than 100 mL/d within 3 days. IFN 1 million units/10 kg was administered for six courses at 4-day intervals. Thirty-day and long-term responses were evaluated under the intention-to-treat principle.
Thirty-day response was 84.3% in the bleomycin arm and 62.3% in IFN arm (P =.002). Median time to progression was 93 days (range, 12 to 395 days) in bleomycin group, and 59 days (range, 7 to 292 days) in the IFN group (P <.001). Median survival was 96 days (range, 15 to 395) and 85 days (range, 16 to 292) in the bleomycin and IFN groups, respectively. Twenty-three patients received two doses of bleomycin, as their daily fluid output remained higher than 100 mL after the first dose. Thirteen of them had complete response, which lasted until death.
Intrapleural bleomycin is more effective than IFN and is a valid option for the palliative treatment of massive, rapidly recurrent malignant pleural effusions. The administration of a second dose of bleomycin to patients not responding to the first one can remarkably improve the overall outcome of the treatment.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antineoplastic agents</subject><subject>Antineoplastic Agents - administration & dosage</subject><subject>Biological and medical sciences</subject><subject>Bleomycin - administration & dosage</subject><subject>Catheterization</subject><subject>Chemotherapy</subject><subject>Chest Tubes</subject><subject>Female</subject><subject>Humans</subject><subject>Instillation, Drug</subject><subject>Interferon-alpha - administration & dosage</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Palliative Care</subject><subject>Pharmacology. Drug treatments</subject><subject>Pleural Effusion, Malignant - diagnostic imaging</subject><subject>Pleural Effusion, Malignant - drug therapy</subject><subject>Pleurodesis</subject><subject>Pneumology</subject><subject>Prospective Studies</subject><subject>Recombinant Proteins</subject><subject>Treatment Outcome</subject><subject>Tumors of the respiratory system and mediastinum</subject><subject>Ultrasonography</subject><issn>0732-183X</issn><issn>1527-7755</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpNUU1v1DAUjBCILoUzN-QL3LK1HX8kx3ZVSlFRV7BF3Cwnee66cuzFTorKH-Pv4dBI5fQ0evPmjWaK4i3Ba0IxPvm8uV7nyda4WRPBnhUrwqkspeT8ebHCsqIlqasfR8WrlO4wJqyu-MviiHDMiZR4VfzZxpAO0I32HtBX7fsw2N_Qo1202qFg0KUfoz44mGLGZw7C8NBZj75DTFOatxANxODRqTO6pC26txrduHyUwuT78mKyfdb7NmjnyrMQAW32kEa0m1pAWWjcA9rmndX_LOwi6HEAP86_v2hnb73OYLsYODdmSjb49Lp4YbRL8GaZx8XNx_Pd5lN5dX1xuTm9KjsmyFgCbkkLjDKRo2ioYH3PuIBGSFwJ2QBpCMMCG66ZFJQ3uNN9JbUkTV-ZDKvj4sOj7iGGn1M2rgabOnBOewhTUpLIOufPM_HkkdjlQFMEow7RDjo-KILV3JXKXam5K4UblbvKF-8W6akdoH_iL-VkwvuFoFOnnYnadzb9xxO8orx-8ri3t_tfNoJKc9pZlqq7LlCqZHZA6-ovXe2rKw</recordid><startdate>20040401</startdate><enddate>20040401</enddate><creator>SARTORI, Sergio</creator><creator>TASSINARI, Davide</creator><creator>CECCOTTI, Piercarlo</creator><creator>TOMBESI, Paola</creator><creator>NIELSEN, Ingrid</creator><creator>TREVISANI, Lucio</creator><creator>ABBASCIANO, Vincenzo</creator><general>American Society of Clinical Oncology</general><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20040401</creationdate><title>Prospective Randomized Trial of Intrapleural Bleomycin Versus Interferon Alfa-2b via Ultrasound-Guided Small-Bore Chest Tube in the Palliative Treatment of Malignant Pleural Effusions</title><author>SARTORI, Sergio ; TASSINARI, Davide ; CECCOTTI, Piercarlo ; TOMBESI, Paola ; NIELSEN, Ingrid ; TREVISANI, Lucio ; ABBASCIANO, Vincenzo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c461t-e0b1be42467329264dd456e96703679e1914060f5a4762590cad37a719d3f5903</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antineoplastic agents</topic><topic>Antineoplastic Agents - administration & dosage</topic><topic>Biological and medical sciences</topic><topic>Bleomycin - administration & dosage</topic><topic>Catheterization</topic><topic>Chemotherapy</topic><topic>Chest Tubes</topic><topic>Female</topic><topic>Humans</topic><topic>Instillation, Drug</topic><topic>Interferon-alpha - administration & dosage</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Palliative Care</topic><topic>Pharmacology. Drug treatments</topic><topic>Pleural Effusion, Malignant - diagnostic imaging</topic><topic>Pleural Effusion, Malignant - drug therapy</topic><topic>Pleurodesis</topic><topic>Pneumology</topic><topic>Prospective Studies</topic><topic>Recombinant Proteins</topic><topic>Treatment Outcome</topic><topic>Tumors of the respiratory system and mediastinum</topic><topic>Ultrasonography</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>SARTORI, Sergio</creatorcontrib><creatorcontrib>TASSINARI, Davide</creatorcontrib><creatorcontrib>CECCOTTI, Piercarlo</creatorcontrib><creatorcontrib>TOMBESI, Paola</creatorcontrib><creatorcontrib>NIELSEN, Ingrid</creatorcontrib><creatorcontrib>TREVISANI, Lucio</creatorcontrib><creatorcontrib>ABBASCIANO, Vincenzo</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of clinical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>SARTORI, Sergio</au><au>TASSINARI, Davide</au><au>CECCOTTI, Piercarlo</au><au>TOMBESI, Paola</au><au>NIELSEN, Ingrid</au><au>TREVISANI, Lucio</au><au>ABBASCIANO, Vincenzo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prospective Randomized Trial of Intrapleural Bleomycin Versus Interferon Alfa-2b via Ultrasound-Guided Small-Bore Chest Tube in the Palliative Treatment of Malignant Pleural Effusions</atitle><jtitle>Journal of clinical oncology</jtitle><addtitle>J Clin Oncol</addtitle><date>2004-04-01</date><risdate>2004</risdate><volume>22</volume><issue>7</issue><spage>1228</spage><epage>1233</epage><pages>1228-1233</pages><issn>0732-183X</issn><eissn>1527-7755</eissn><abstract>To compare bleomycin pleurodesis and immunotherapy with intrapleural interferon alfa-2b (IFN) in the palliation of malignant pleural effusions.
One hundred sixty patients with rapidly recurrent malignant pleural effusion were randomly assigned to intrapleural bleomycin (83 patients) or IFN (77 patients). A 9-French intrapleural catheter was placed under sonographic guidance, and pleural effusion was completely drained before starting the treatment. Bleomycin 0.75 mg/kg was administered as a single dose. An additional dose was given if daily fluid output did not drop to less than 100 mL/d within 3 days. IFN 1 million units/10 kg was administered for six courses at 4-day intervals. Thirty-day and long-term responses were evaluated under the intention-to-treat principle.
Thirty-day response was 84.3% in the bleomycin arm and 62.3% in IFN arm (P =.002). Median time to progression was 93 days (range, 12 to 395 days) in bleomycin group, and 59 days (range, 7 to 292 days) in the IFN group (P <.001). Median survival was 96 days (range, 15 to 395) and 85 days (range, 16 to 292) in the bleomycin and IFN groups, respectively. Twenty-three patients received two doses of bleomycin, as their daily fluid output remained higher than 100 mL after the first dose. Thirteen of them had complete response, which lasted until death.
Intrapleural bleomycin is more effective than IFN and is a valid option for the palliative treatment of massive, rapidly recurrent malignant pleural effusions. The administration of a second dose of bleomycin to patients not responding to the first one can remarkably improve the overall outcome of the treatment.</abstract><cop>Baltimore, MD</cop><pub>American Society of Clinical Oncology</pub><pmid>15051770</pmid><doi>10.1200/JCO.2004.09.164</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0732-183X |
| ispartof | Journal of clinical oncology, 2004-04, Vol.22 (7), p.1228-1233 |
| issn | 0732-183X 1527-7755 |
| language | eng |
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| source | MEDLINE; American Society of Clinical Oncology; EZB Electronic Journals Library |
| subjects | Adult Aged Aged, 80 and over Antineoplastic agents Antineoplastic Agents - administration & dosage Biological and medical sciences Bleomycin - administration & dosage Catheterization Chemotherapy Chest Tubes Female Humans Instillation, Drug Interferon-alpha - administration & dosage Male Medical sciences Middle Aged Palliative Care Pharmacology. Drug treatments Pleural Effusion, Malignant - diagnostic imaging Pleural Effusion, Malignant - drug therapy Pleurodesis Pneumology Prospective Studies Recombinant Proteins Treatment Outcome Tumors of the respiratory system and mediastinum Ultrasonography |
| title | Prospective Randomized Trial of Intrapleural Bleomycin Versus Interferon Alfa-2b via Ultrasound-Guided Small-Bore Chest Tube in the Palliative Treatment of Malignant Pleural Effusions |
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