Indwelling pleural catheter versus talc pleurodesis for malignant pleural effusion: a meta-analysis
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RESEARCH PAPER
Indwelling pleural catheter versus talc pleurodesis for malignant pleural effusion: a meta-analysis Maggie Yeung1 · El‑Wui Loh2,3 · Tung‑Yu Tiong4 · Ka‑Wai Tam2,5,6,7 Received: 7 February 2020 / Accepted: 5 June 2020 © Springer Nature B.V. 2020
Abstract Malignant pleural effusion (MPE) results from primary mesothelioma or the spreading of metastatic cancer. Both talc pleurodesis (TP) and indwelling pleural catheter (IPC) improve MPE symptoms. We performed a meta-analysis of randomized controlled trials to compare the efficacy of TP with that of IPC in patients with MPE. PubMed, EMBASE, Cochrane Library, and ClinicalTrials.gov databases were searched for studies published before February 2020. Individual effect sizes were standardized, and a meta-analysis was conducted to calculate a pooled effect size by using random effects models. In total, 4 trials with 500 patients were reviewed. Difference in pleurodesis success rate and change in dyspnea scores at 4 and 6 weeks between MPE patients treated with IPC and those treated with TP for pleurodesis were nonsignificant. The number of hospital inpatient days was significantly lower among patients who were treated with IPC (weight mean difference: 2.19; 95% confidence interval 0.70–3.67) than among those who were treated with TP. No significant difference was shown in adverse event profile between patients treated with IPC and those treated with TP for pleurodesis. In conclusion, both TP and IPC are equally effective in treating patients with MPE. The number of hospitalization days was significantly lower for patients who were treated with IPC, but the magnitude of the difference is of uncertain clinical importance. Keywords Malignant pleural effusion · Talc pleurodesis · Indwelling pleural catheter · Meta-analysis
* Ka‑Wai Tam [email protected] 1
Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
2
Centre for Evidence‑Based Health Care, Shuang Ho Hospital, Taipei Medical University, 291, Zhongzheng Road, Zhonghe District, New Taipei City 23561, Taiwan
3
Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
4
Division of Thoracic Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
5
Division of General Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
6
Division of General Surgery, Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
7
Cochrane Taiwan, College of Medicine, Taipei Medical University, Taipei, Taiwan
Abbreviations CI Confidence interval EQ-5D-5 L EuroQoL Group 5-Dimensions 5-Level Questionnaire IPC Indwelling pleural catheter MBS Modified Borg Scale MeSH Medical subject headings MPE Malignant pleural effusion QLQ-C30 quality of life questionnaire-core 30 QoL Quality of life RCT Randomized controlled trials RoB Risk of bias RR Risk ratios TP Talc pleurodes
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