| 악성 흉막액 및 심낭액 치료에 대한 Bleomycin 주입치료의 효과 |
| 임헌관, 이명렬, 전진우, 박성규, 원종호, 백승호, 홍대식, 박희숙 |
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| Intracavitary Therapy with Bleomycin for The Treatment of Malignant Pleural and Pericardial Effusion |
| Hun Kwan Lim, Myung Lyel Lee, Jin Woo Jeon, Seong Gyu Park, Jong Ho Won, Seung Ho Baik, Dae Sik Hong, Hee Sook Park |
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| ABSTRACT |
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Pleural effusions caused by malignancy occur commonly and are generally a manifestation of the advanced disease. Regardless of the underlying tumor type, mertality within 30 days has been reported to be as high as 50%. Respiratory insufficiency due to malignant pleural effusion often demands palliative management of the effusion. Malignant pericardial effusion is one of the most common causes of cardiac tamponade. Bleomycin and tetracycline have been widely used as sclerosing agents in malignant pleural effusion in North America and Europe. Bleomycin is less often used in the malignant pericardial effusion but is efficacious. Our study was begun to assess the effect and safety of bleomycin pleurodesis/pericardiodesis. Prospectively assigned twenty patients with malignant effusion(pleural effusion: 15, pericardial effusion; 5) to this therapy. Their age ranged from 19 to 69 years with a median of 47 years. Pri- mary sites were lung in 10, colon in 2, stomach, breast, uterine cervix, leg(sarcoma), mediastinum(malignant lymphoma), kidney in 1 each and unknown in 2(malignant melanoma and adenocarcinoma). The responses were categorized as objective response or failure. Twelve patients(70.5%) showed an objective response(complete response: 47% (8 cases), partial response: 23.5% (4 cases) out of 17 evaluable cases and the duration ranged from 5 to 78 weeks with a me- dian of 16 weeks. The response rates of malignant pericardial effusion and pleural effusion were 100/ and 61.5% respectively. Chest pain(10/17), and fever and/or chill(9/17) were the most common side effects. Other untoward effects included vomiting(4/17), anorexia(3/17), hypersensitivity(1/17), pyothorax(l/17). We conclude that bleomycin pleurodesis and pericardiodesis in malignant effusion can be performed safely and show good treatment effects, especially in maiignant pericardial effusion. |
| Key words:
Malignant effusion, Bleomycin, Pleurodesis, Pericardiodesis |
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