PURPOSE: Malignant pleural effusions (MPE) are a common problem associated with advanced malignancy. Tunneled pleural catheters (TPC) have emerged as a new technique in the treatment of recurrent malignant effusions. The impact of this palliative procedure on patient quality of life (QoL) and objective measures of dyspnea have not been well described.
METHODS: Patients with recurrent MPE considered appropriate candidates for TPC insertion were recruited from four cancer centers across Canada. Patients were asked to complete the EORTC QLQ-C30 and LC13 QoL questionnaires at baseline, and at 2 and 14 week clinical follow-up visits. This preliminary analysis aims to compare QoL and dyspnea scores between baseline and 2 weeks post-TPC insertion.
RESULTS: A total of 81 patients were recruited into the study, 46% male and 54% female. Distribution of malignancies was 45% lung primary; 15% breast; 11% mesothelioma; and 6% ovarian . Two week data was available in 68/81 (84%) of subjects. There was a significant improvement in global health status and overall quality of life (mean score at 2 weeks, 47.5; difference from baseline, 9.2 [95% CI 13.9, 4.5], p<0.001). There was also an improvement in dyspnea scores in both the EORTC QLQ-C30 (mean score at 2 weeks, 64.6; difference from baseline, 17.4 [95% CI 8.0, 26.7], p=0.001) and LC13 (mean score at 2 weeks, 49.0; difference from baseline, 17.9 [95% CI 10.2, 25.6], p<0.001) questionnaires, as well as improvements in MRC score (median score of 3 at 2 weeks, median baseline score 4, p <0.001).
CONCLUSIONS: Tunneled pleural catheters are associated with a significant improvement in global health status, quality of life, and dyspnea at the 2 week time point in patients with recurrent malignant pleural effusions.
CLINICAL IMPLICATIONS: The use of tunneled pleural catheters in patients with recurrent MPE improves symptoms and quality of life, even if pleurodesis is not the focus of treatment.
DISCLOSURE: Alain Tremblay: Consultant fee, speaker bureau, advisory committee, etc.: Dr. Tremblay has received consulting fees from CareFusion Inc, Other: Dr. Tremblay holds a patent pending on a method to treat malignant pleural effusions.
The following authors have nothing to disclose: Natasha Sabur, Alex Chee, Elaine Dumoulin, David Stather, Paul MacEachern, Chris Hergott, Anne Gonzalez, Kayvan Amjadi
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