癌性胸膜炎に対するＰａｃｌｉｔａｘｅｌによる２４時間腔内治療を用いた集学的治療

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  • The Use of Paclitaxel Administered by 24-hour Intrathoracic Infusion for Patients With Carcinomatous Pleuritis

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Background. For successful intrapleural chemotherapy, efforts should be made to maintain the intrapleural drug activity as long as possible. In this interim report, the effectiveness of paclitaxel administered by 24-hour intrathoracic infusion as an adjunct to selective surgical management and/or systemic chemotherapy for controlling malignant pleural effusions is described. Methods. Between October 2001 and May 2004, 10 patients with carcinomatous pleuritis were enrolled in the study. The primary sites of the diseases were the lung in 9 patients and the breast in one patient. Paclitaxel (120 mg/m2) was administered by 24-hour intrathoracic infusion. Six of the 10 patients selectively underwent surgical treatment and 9 patients received adjuvant systemic chemotherapy. The operative procedures used were partial resection of the primary site plus parietal pleurectomy (PL) in 2 cases, lobectomy plus PL in 2 cases, PL only in one case, and chest wall resection plus PL in one case. Results. In patients who underwent surgery, the mean time interval between the operation and intrapleural chemotherapy was 7.7 days (range 3-16 days). Mild toxicity was found in 5 cases, and chest pain and neutropenia were dominant. During a median follow-up period of 19 months (range, 3-33 months), malignant effusions were successfully controlled in 8 patients and the median survival period was 18 months. Conclusion. The use of paclitaxel in this manner merits further investigation for possible intervention for malignant pleural effusions originating in lung and breast neoplasms.

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  • 肺癌

    肺癌 44 (7), 753-758, 2004

    特定非営利活動法人 日本肺癌学会

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