Display options
Cite
Hojski A, Leitgeb M, Crnjac A. Release of growth factors after mechanical and chemical pleurodesis for treatment of malignant pleural effusion: a randomized control study. Radiol Oncol. 2015;49(4):386-94doi: 10.1515/raon-2015-0002.
Hojski, A., Leitgeb, M., & Crnjac, A. (2015). Release of growth factors after mechanical and chemical pleurodesis for treatment of malignant pleural effusion: a randomized control study. Radiology and oncology, 49(4), 386-94. https://doi.org/10.1515/raon-2015-0002
Hojski, Aljaz, et al. "Release of growth factors after mechanical and chemical pleurodesis for treatment of malignant pleural effusion: a randomized control study." Radiology and oncology vol. 49,4 (2015): 386-94. doi: https://doi.org/10.1515/raon-2015-0002
Hojski A, Leitgeb M, Crnjac A. Release of growth factors after mechanical and chemical pleurodesis for treatment of malignant pleural effusion: a randomized control study. Radiol Oncol. 2015 Nov 27;49(4):386-94. doi: 10.1515/raon-2015-0002. eCollection 2015 Dec. PMID: 26834526; PMCID: PMC4722930.
Copy Download .nbib Format: NLM
Share it on

Radiol Oncol. 2015 Nov 27;49(4):386-94. doi: 10.1515/raon-2015-0002. eCollection 2015 Dec.

Release of growth factors after mechanical and chemical pleurodesis for treatment of malignant pleural effusion: a randomized control study.

Radiology and oncology

Aljaz Hojski, Maja Leitgeb, Anton Crnjac

Affiliations

  1. Department of Thoracic Surgery, University Medical Centre Maribor, Slovenia.
  2. Biochemistry Division, Medical Faculty, University of Maribor, Maribor Slovenia.

PMID: 26834526 PMCID: PMC4722930 DOI: 10.1515/raon-2015-0002

Abstract

BACKGROUND: Growth factors are key inducers of fibrosis but can also mediate inflammatory responses resulting in increasing pleural effusion and acute respiratory distress syndrome. The primary aim of the study was to analyse growth factors release after performing chemical and mechanical pleurodesis in the first 48 hours at the patients with malignant pleural effusion. The secondary endpoints were to evaluate the effectiveness of the both pleurodeses, symptoms release and the quality of life of patients after the treatment.

PATIENTS AND METHODS: A prospective randomized study included 36 consecutive female patients with breast carcinoma and malignant pleural effusion in an intention-to-treat analysis. We treated 18 patients by means of thoracoscopic mechanical pleurodesis and 18 patients by chemical pleurodesis with talcum applied over a chest tube. We gathered the pleural fluid and serum samples in the following 48 hours under a dedicated protocol and tested them for growth factors levels. A quality of life and visual analogue pain score surveys were also performed.

RESULTS: Median measured serum vascular endothelial growth factor (VEGF) level after chemical pleurodesis was 930.68 pg/ml (95% CI: 388.22-4656.65) and after mechanical pleurodesis 808.54 pg/ml. (95% CI: 463.20-1235.13) (p = 0.103). Median pleural levels of transforming growth factor (TGF) β1 were higher after performing mechanical pleurodesis (4814.00 pg/ml [95% CI: 2726.51-7292.94]) when compared to those after performing chemical pleurodesis (1976.50 pg/ml [95% CI: 1659.82-5136.26]) (p = 0.078). We observed similar results for fibroblast growth factor (FGF) β; the serum level was higher after mechanical pleurodesis (30.45 pg/ml [95% CI: 20.40-59.42]), compared to those after chemical pleurodesis (13.39 pg/ml [95% CI: 5.04 - 74.60]) (p = 0.076). Mechanical pleurodesis was equally effective as chemical pleurodesis in terms of hospital stay, pleural effusion re-accumulation, requiring of additional thoracentesis, median overall survival, but, it shortened the mean thoracic drainage duration (p = 0.030) and resulted in a higher symptoms release and in a better quality of life (p = 0.047).

CONCLUSIONS: We recorded an increase in serum VEGF levels after chemical pleurodesis, however on the contrary, an increase in the pleural fluid level of TGFβ1 and FGFβ] after mechanical pleurodesis with respect to compared group. Although the differences did not reach statistical significance, VEGF, TGFβ1 and FGFβ remain the most interesting parameters for future research. Considering the mechanisms of growth factors action, we conclude that in our study group mechanical pleurodesis might be more efficient in terms of growth factors release, thoracic drainage duration and resulted in a higher symptoms release and in a better quality of life than chemical pleurodesis.

Keywords: growth factors; malignant pleural effusion; pleurodesis; quality of life

References

  1. Radiol Oncol. 2014 Jan 22;48(1):80-6 - PubMed
  2. Wound Repair Regen. 2009 Mar-Apr;17(2):153-62 - PubMed
  3. Radiol Oncol. 2014 Apr 25;48(2):184-8 - PubMed
  4. Eur J Cardiothorac Surg. 2011 Aug;40(2):277-9 - PubMed
  5. Clin Cancer Res. 1999 Nov;5(11):3364-8 - PubMed
  6. J Transl Med. 2012 Sep 03;10:183 - PubMed
  7. Lung Cancer. 2011 Dec;74(3):392-5 - PubMed
  8. Eur J Cardiothorac Surg. 2006 May;29(5):829-38 - PubMed
  9. J Mammary Gland Biol Neoplasia. 2005 Oct;10(4):283-90 - PubMed
  10. Am J Respir Crit Care Med. 2001 Nov 1;164(9):1601-5 - PubMed
  11. J BUON. 2006 Oct-Dec;11(4):463-7 - PubMed
  12. Chest. 2004 Nov;126(5):1522-8 - PubMed
  13. J Natl Cancer Inst. 1993 Mar 3;85(5):365-76 - PubMed
  14. Chest. 2014 May;145(5):1141-3 - PubMed
  15. Lung Cancer. 2012 Aug;77(2):443-9 - PubMed
  16. Respir Med. 2009 Jan;103(1):91-7 - PubMed
  17. Radiol Oncol. 2013 Mar;47(1):57-62 - PubMed
  18. Am J Respir Crit Care Med. 2001 Mar;163(3 Pt 1):640-4 - PubMed
  19. Respir Med. 2009 Apr;103(4):595-600 - PubMed
  20. Eur J Cardiothorac Surg. 2004 Aug;26(2):432-6 - PubMed
  21. Interact Cardiovasc Thorac Surg. 2011 May;12(5):818-23 - PubMed
  22. Int J Biochem Cell Biol. 2004 Jun;36(6):1031-7 - PubMed
  23. Wien Klin Wochenschr. 2006 Aug;118(15-16):479-84 - PubMed
  24. Neoplasma. 2004;51(5):334-40 - PubMed
  25. Anticancer Drugs. 2012 Feb;23(2):230-8 - PubMed
  26. Lung Cancer. 2004 Sep;45(3):325-37 - PubMed
  27. Clin Chest Med. 2013 Mar;34(1):xi - PubMed
  28. Wien Klin Wochenschr. 2004;116 Suppl 2:28-32 - PubMed
  29. Respir Med. 2008 Dec;102(12):1708-14 - PubMed

Publication Types