TY - JOUR
T1 - Indwelling pleural catheter versus talc pleurodesis for malignant pleural effusion
T2 - a meta-analysis
AU - Yeung, Maggie
AU - Loh, El Wui
AU - Tiong, Tung Yu
AU - Tam, Ka Wai
N1 - Publisher Copyright:
© 2020, Springer Nature B.V.
PY - 2020/8/1
Y1 - 2020/8/1
N2 - 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.
AB - 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.
KW - Indwelling pleural catheter
KW - Malignant pleural effusion
KW - Meta-analysis
KW - Talc pleurodesis
KW - Catheterization
KW - Drainage/methods
KW - Humans
KW - Length of Stay/statistics & numerical data
KW - Catheters, Indwelling/adverse effects
KW - Quality of Life/psychology
KW - Randomized Controlled Trials as Topic
KW - Mesothelioma/pathology
KW - Pleural Effusion, Malignant/therapy
KW - Pleurodesis/methods
KW - Talc/therapeutic use
UR - http://www.scopus.com/inward/record.url?scp=85086398434&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85086398434&partnerID=8YFLogxK
U2 - 10.1007/s10585-020-10042-2
DO - 10.1007/s10585-020-10042-2
M3 - Article
C2 - 32524317
AN - SCOPUS:85086398434
SN - 0262-0898
VL - 37
SP - 541
EP - 549
JO - Clinical and Experimental Metastasis
JF - Clinical and Experimental Metastasis
IS - 4
ER -