Cancer Research and Treatment

Intrapleural Chemotherapy with Cisplatin and Cytarabine in the Management of Malignant Pleural Effusion: Kee Won Kim, Suk Young Park, Myung Sook Kim, Seok Chan Kim, Eun Hee Lee, So Young Shin, Jong Ho Lee, Jong Bum Kweon, Kuhn Park; Cancer Res Treat. 2004;36(1):68-71. Published online February 29, 2004; DOI: https://doi.org/10.4143/crt.2004.36.1.68

Purpose

The purpose of this study was to evaluate the efficacy of intrapleural chemotherapy (IPC) with cisplatin and cytarabine in the management of malignant pleural effusion (MPE) from non-small-cell lung cancer (NSCLC).

Materials and Methods

A prospective analysis was carried out on 40 patients with pathologically proven MPE from NSCLC who had received IPC. A single dose of cisplatin 100 mg/m² plus cytarabine 1200 mg/m² in 250 ml normal saline was instilled into the pleural space via a chest tube and drained 4 hours later. Patients were evaluated for toxicities and responses at 1, 2, & 3 weeks and then at monthly intervals if possible. Systemic chemotherapy was administered, if the patient agreed to receive it, after achieving complete control (CC) of MPE.

Results

The median duration of chest tube insertion for drainage was 7 (3~32) days. Among the assessable 37 patients, CC and partial control (PC) were 32 (86.5%) and 4 (10.8%) patients, respectively (overall response rate 97.3%). The median duration of response was 12 months (2~23) and there were only two relapses of IPC after achieving CC. Among the 35 patients who were assessable until they died, 28 patients (80.0%) maintained CC until the last follow-up. There was only one toxic death and the toxicities of IPC, versus the results obtained, were deemed acceptable.

Conclusion

The procedures were tolerable to the patients and chemotherapy-induced complications were at an acceptable level. The outcome of this trial indicates that IPC has a superior and long lasting treatment response in the management of patients with MPE from NSCLC.

Citations

Citations to this article as recorded by

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Expression of P53, Bcl-2, Bax, and P-glycoprotein in Relation to Chemotherapeutic Response in Patients with Advanced Non-Small-Cell Lung Cance: Suk Young Park, Eun Hee Lee, Kee Won Kim, Chul Seung Kay, Seok Chan Kim, Ji Won Suhr, Kyung Shick Lee; J Korean Cancer Assoc. 2001;33(2):158-162.

Abstract PDF: PURPOSE
To evaluate the relationship between the expressions of p53, bcl-2, bax, and p-glycoprotein and the chemotherapeutic response seen in patients with advanced NSCLC.
MATERIALS AND METHODS
Forty-four patients pathologically proven as NSCLC were reviewed. They had undergone at least two cycles of the same chemotherapeutic agents (cisplatin 60 mg/m2 day 1+ vinorelbine 25 mg/m2 day 1, 8, 21-day cycle) and the clinical response was evaluated by WHO criteria. The expressions of p53, bcl-2, bax, and p-glycoprotein were determined by immunohistochemistry.
RESULTS
Patients recorded as CR (2/44) and PR (20/44) were classified as the responder group (22/44) and stable (17/44) and progression (5/44) as the non-responder group (22/44). Positive expression of p53, bcl-2, bax, and p-glycoprotein were 84.1%, 65.9%, 88.6%, and 61.4% respectively. The expression score of p53 was significantly higher in the non-responder group than that seen in the responder group (8.59+/-1.89 vs 5.32+/-2.15, p<0.05). However, the expression scores of bcl-2, bax, and p-glycoprotein were not significantly correlated with the clinical response.
CONCLUSION
This study suggests that p53 gene mutation plays an important role in the clinical response to chemotherapy including cisplatin and vinorelbine. In future investigations, the correlation with the survival time will be studied.

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Combination Chemotherapy with Cisplatin and Vinorelbine in Patients with Non-Small-Cell Lung Cancer: Kee Won Kim, Suk Young Park, Ji Won Suhr, Seung Joon Kim, Dong Hoen Yang, Eun Hee Lee, Kyung Shick Lee; J Korean Cancer Assoc. 2000;32(5):911-917.

Abstract PDF: PURPOSE
To determine the therapeutic effect and toxicities of cisplatin and vinorelbine combination chemotherapy in patients with inoperable non-small-cell lung cancer.
MATERIALS AND METHODS
Between Jan 1998 and Dec 1999, 28 patients with inoperable non- small-cell lung cancer were treated with cisplatin and vinorelbine combination chemotherapy as induction treatment. A combination of vinorelbine 25 mg/m2 day 1,8 and cisplatin 60 mg/m2 day 1 were given and repeated every 3 weeks. Then we assessed response and toxicity according to WHO grades.
RESULTS
According to response criteria, there were 1 complete response, 12 partial response (42.9%), 12 stable disease (42.9%), and 3 progression (10.7%). The median survival was 12 months. According to toxicity grades, 24 grade 3 myelosuppression (24.7%), 12 grade 4 myelo suppression (10.7%), 6 grade 3 and 4 constipation (6.1%), and mild 7 (7.2%) thrombophlebitis were experienced in evaluable 97 cycles. There was no other clinically severe toxicity.
CONCLUSION
These results suggest that combination chemotherapy with cisplatin and vinorelbine in patients with inoperable non-small-cell lung cancer was effective and safe.

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The Site-dependent Differences in Response to Chemotherapy in Patients with Advanced Lung Cancer: Kee Won Kim, Sook Kyung Lee, Jee Won Seo, Suk Young Park, Kyung Shik Lee; J Korean Cancer Assoc. 1999;31(3):533-538.

Abstract PDF: PURPOSE
To detennine the extent and the clinical significance of site-dependent differences in response to chemotherapy in patients with metastatic lung cancer.
MATERIALS AND METHODS
We reviewed the records of patients with metastatic lung cancer who had received chemotherapy and were evaluated for the response of primary lung and metastatic lesions simultaneously. Total 52 patients were eligible.
RESULTS
The discordance rate of response between primary lung lesion and various metastatic lesions was 0% (0/51) at regional lymph nodes, 12% (1/8) at distant lymph nodes, 45% (5/11) at hematogenous metastatic lung lesion, 0% (0/7) at liver, 50% at adrenal glands, and 21% (3/14) at bone. As a result, the concordance rate of response amang lymph nodes, liver, and primary lung lesions was high. But some differences in response were observed at intrapulmonary metastatic lesion, adrenal glands, and bone lesions in comparison with primary lung lesion.
CONCLUSION
We conclude that the effective therapeutic strategies against those discordant metastatic lesions should be developed to increase the overall treatment effect in patients with metastatic lung cancer.

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A case of malignant lymphoma developed after gastric pseudolymphoma resection: Kee Won Kim, Chang Hyun Choi, Jong Ho Won, Dae Sik Hong, Hee Sook Park, So Young Jin, Dong Wha Lee; J Korean Cancer Assoc. 1992;24(1):187-193.

Abstract PDF: No abstract available.

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