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J Korean Cancer Assoc > Volume 31(6); 1999 > Article
Journal of the Korean Cancer Association 1999;31(6): 1297-1306.
Intracavitary 166 Holmium - chitosan Complex Therapy in Patients with Malignant Peritoneal or Pleural Effusions
Do Yeun Cho, Hyun Soo Kim, Joon Seong Park, Cheol Kweon Jeong, Jin Hyuk Choi, Ho Yeong Lim, Chan Hee Park, Mi Son Chun, Young Mi Kim, Kyung Bae Park, Hugh Chul Kim
1Department of Hematology-Oncology, Ajou University Hospital, School of Medicine, Suwon, Korea.
2Department of Nuclear Medicine, Ajou University Hospital, School of Medicine, Suwon, Korea.
3Department of Radiation Oncology, Ajou University Hospital, School of Medicine, Suwon, Korea.
4Korea Atomic Energy Research Institute, Korea.
Most malignant peritoneal or pleural effusions caused by advanced malignancy are unresponsive to systemic chemotherapy except for chemotherapy sensitive tumors, and they are equally ineffective to regional therapy or radiotherapy. Thus, for the purpose of palliating the symptoms related to malignant effusion and to reduce fluid reaccumulations, we evaluated the therapeutic feasibility and efficacy of intracavitary ' Ho-CHICO (chito- san complex) instillation for intractable malignant effusions.
Thirty one patients with cytologically or pathologically proven malignant effusions underwent intracavitary 166Ho-CHICO therapy from May 1996 to March 1998 at Ajou University Hospital. The subjective and objective responses were evaluated 4 weeks after the treatment, including the changes of symptoms, weight, abdominal girth, doses of diuretics, frequencies and amounts of repeat aspirations for fluid reaccumulations, and imaging studies of chest radiograph and ultrasounds.
The response rates treated with Ho-CHICO were 50% in patients with peritoneal effusion and 46% in patients with pleural effusion (overall 49%). The response rates between 166Ho-CHICO doses of 50-80 mCi and 90-100 mCi were similar (50% vs 47%). Response rate of 70% was noted in patients with even distribution of radioisotope on the post-therapy scan, but, the response rate was lower in cases with focal (44%) and uneven (29%) distribution pattern. There was no difference in response by the effusion sites. All patients tolerated intracavitary 166Ho-CHICO instillation well, although the majority of patients experienced Grade I/II side effects such as pain, fever, weakness and dyspnea. But, no serious complications of Grade lII or IV degree were observed with 166Ho-CHICO therapy.
Intracavitary 166Ho-CHICO instillation was clinically efficacious in controlling malignant effusions without a significant toxicity seen with conventional sclerotic therapy. The therapeutic modality appeared to offer similar benefits obtained with the conventional intracavitary therapy.
Key words: Malignant effusions
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