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Abstract
Malignant pleural effusion in breast cancer has been associated with poor prognosis. The response rate of local treatment has been very low and in some case, complications have resulted in death. We investigated the efficacy and safety of paclitaxel, as an intrapleural chemotherapeutic agent. From January 2006 to December 2009, ten breast cancer patients who had developed malignant pleural effusion were infused with intrapleural paclitaxel through a chest tube, which was clamped for 48 hours. The chest tube was maintained until drainage was reduced to less than 50-100 mL/day. The average time spent with a chest tube attached following intrapleural chemotherapy was 9.3 days. During the follow-up period, six patients had no recurrent pleural effusion and two received a second round of intrapleural chemotherapy following which no further pleural effusion recurred. There were no severe side effects except for mild toxicity. It is suggested that intrapleural paclitaxel chemotherapy may be superior to conventional local treatment and may represent an effective treatment modality with low toxicity.
Figures and Tables
Figure 1
Chest CT scan performed on admission. Chest CT scan obtained in a 43-yr-old woman who presented with dyspnea shows a large amount of right pleural effusion with total collapse of the right lung.
Figure 2
Three months after intrapleural chemotherapy. Significant decrease of pleural effusion was seen and right lung re-expanded fully.
Table 1
Patient characteristics: primary breast cancer
ER=estrogen receptor; PR=progesterone receptor; MRM=modified radical mastectomy; CMF=Cyclophosphamide+methotrexate+5-fluorouracile; NASSM=nipple-areola preserving skin-sparing mastectomy; ALND=axillary lymph node dissection; FEC=5-fluorouracile+epirubicin+cyclophosphamide; BCS=breast conserving surgery; AC=adriamycin+cyclophosphamide; SLND=sentinel lymph node dissection; FAC=5-fluorouracile+adriamycin+cyclophosphamide.
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