Viscum pleurodesis is as effective as talc pleurodesis and tends to have less adverse effect
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ORIGINAL ARTICLE
Viscum pleurodesis is as effective as talc pleurodesis and tends to have less adverse effect YongJin Chang 1
&
DeogGon Cho 1 & KyuDo Cho 1 & MinSeop Cho 1
Received: 18 July 2019 / Accepted: 6 March 2020 # The Author(s) 2020
Abstract Purpose Many patients diagnosed with advanced cancer have malignant pleural effusion that does not respond to chemotherapy or radiation therapy. These patients often have respiratory symptoms, especially dyspnea. In order to relieve these symptoms, various procedures including chemical pleurodesis have been performed. Although talc is the most widely used and effective sclerosing agent, there it has various adverse effects. The objective of this study was to determine whether Viscum (ABNOVA Viscum® Fraxini Injection, manufactured by ABNOVA GmbH, Germany) could be used as an agent to replace talc in clinical practice. Methods Data of 56 patients with malignant pleural effusion who received chemical pleurodesis after tube thoracostomy from January 2003 to December 2017 were retrospectively reviewed to analyze clinical course and response after pleurodesis with each agent. Results After pleurodesis, changes in numeric rating scale (NRS) was 1.4 ± 1.6 in the talc group and 0.5 ± 1.5 in the Viscum group (p = 0.108). Changes in white blood cell counts after pleurodesis were 4154.8 ± 6710.7 in the talc group and 3487.3 ± 6067.7 in the Viscum group (p = 0.702). Changes in C-reactive protein (CRP) were 9.03 ± 6.86 in the talc group and 6.3 ± 7.5 in the Viscum group (p = 0.366). The success rate of pleurodesis was 93.3% in the talc group and 96% in the Viscum group (p = 0.225). Conclusion Viscum pleurodesis showed comparable treatment results with talc pleurodesis while its adverse effects such as chest pain and fever tended to be relatively weak. Keywords Malignant pleural effusion . Chemical pleurodesis . Talc . Viscum
Introduction The ultimate goal of treatment for patients with malignant pleural effusion (MPE) is to increase quality of life during life
* YongJin Chang [email protected] DeogGon Cho [email protected] KyuDo Cho [email protected] MinSeop Cho [email protected] 1
Department of Thoracic and Cardiovascular Surgery, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
expectancy. These patients often have respiratory symptoms. Repeat thoracentesis, pig tailed catheter drainage, or tube thoracostomy is often used to relieve patient’s symptoms. However, such procedure itself can degrade the quality of life. Therefore, chemical pleurodesis is generally recommended to help patients feel at ease. In the past and now, talc is generally used as a sclerosing agent for chemical pleurodesis [1, 2]. Many researchers have made efforts to select sclerosing agents that are as effective as talc. Unfortunately, previous studies have focused on the “final therapeutic outcome” of chemical pleurodesis using talc and several sclerosing agents without focusing on “patient’s discomfort” during pleurodesis. The authors i
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