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Naslov:Release of growth factors after mechanical and chemical pleurodesis for treatment of malignant pleural effusion : a randomized control study
Avtorji:Hojski, Aljaž (Avtor)
Leitgeb, Maja (Avtor)
Crnjac, Anton (Avtor)
Datoteke:.pdf Radiology_and_Oncology_2015_Hojski,_Leitgeb,_Crnjac_Release_of_growth_factors_after_mechanical_and_chemical_pleurodesis_for_treatment_of.pdf (689,93 KB)
 
URL http://www.degruyter.com/view/j/raon.2015.49.issue-4/raon-2015-0002/raon-2015-0002.xml
 
Jezik:Angleški jezik
Vrsta gradiva:Znanstveno delo (r2)
Tipologija:1.01 - Izvirni znanstveni članek
Organizacija:MF - Medicinska fakulteta
Opis:Background: Growth factors are key inducers of fibrosis but can also mediate inflammatory responses resulting in increasing pleural effusion and acute respiratory distress syndrome. The primary aim of the study was to analyse growth factors release after performing chemical and mechanical pleurodesis in the first 48 hours at the patients with malignant pleural effusion. The secondary endpoints were to evaluate the effectiveness of the both pleurodeses, symptoms release and the quality of life of patients after the treatment. Patients and methods: A prospective randomized study included 36 consecutive female patients with breast carcinoma and malignant pleural effusion in an intention-to-treat analysis. We treated 18 patients by means of thoracoscopic mechanical pleurodesis and 18 patients by chemical pleurodesis with talcum applied over a chest tube. We gathered the pleural fluid and serum samples in the following 48 hours under a dedicated protocol and tested them for growth factors levels. A quality of life and visual analogue pain score surveys were also performed. Results: Median measured serum vascular endothelial growth factor (VEGF) level after chemical pleurodesis was 930.68 pg/ml (95% CI: 388.22-4656.65) and after mechanical pleurodesis 808.54 pg/ml. (95% CI: 463.20-1235.13) (p = 0.103). Median pleural levels of transforming growth factor (TGF) ß1 were higher after performing mechanical pleurodesis (4814.00 pg/ml [95% CI: 2726.51-7292.94]) when compared to those after performing chemical pleurodesis (1976.50 pg/ml [95% CI: 1659.82-5136.26]) (p = 0.078). We observed similar results for fibroblast growth factor (FGF) ß; the serum level was higher after mechanical pleurodesis (30.45 pg/ml [95% CI: 20.40-59.42]), compared to those after chemical pleurodesis (13.39 pg/ml [95% CI: 5.04-74.60]) (p = 0.076). Mechanical pleurodesis was equally effective as chemical pleurodesis in terms of hospital stay, pleural effusion re-accumulation, requiring of additional thoracentesis, median overall survival, but, it shortened the mean thoracic drainage duration (p = 0.030) and resulted in a higher symptoms release and in a better quality of life (p = 0.047). Conclusions: We recorded an increase in serum VEGF levels after chemical pleurodesis, however on the contrary, an increase in the pleural fluid level of TGF%1 and FGF%] after mechanical pleurodesis with respect to compared group. Although the differences did not reach statistical significance, VEGF, TGFß1 and FGFß remain the most interesting parameters for future research. Considering the mechanisms of growth factors action, we conclude that in our study group mechanical pleurodesis might be more efficient in terms of growth factors release, thoracic drainage duration and resulted in a higher symptoms release and in a better quality of life than chemical pleurodesis.
Ključne besede:malignant pleural effusion, pleurodesis, growth factors, quality of life
Leto izida:2015
Št. strani:str. 386-394
Številčenje:št. 4, Letn. 49
ISSN:1318-2099
UDK:616.25-006
COBISS_ID:18435094 Povezava se odpre v novem oknu
DOI:10.1515/raon-2015-0002 Povezava se odpre v novem oknu
ISSN pri članku:1318-2099
NUK URN:URN:SI:UM:DK:TGYTXBAG
Licenca:CC BY-NC-ND 4.0
To delo je dosegljivo pod licenco Creative Commons Priznanje avtorstva-Nekomercialno-Brez predelav 4.0 Mednarodna
Število ogledov:534
Število prenosov:42
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Področja:Ostalo
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Gradivo je del revije

Naslov:Radiology and Oncology
Skrajšan naslov:Radiol. Oncol.
Založnik:De Gruyter Open
ISSN:1318-2099
COBISS.SI-ID:32649472 Novo okno

Sekundarni jezik

Jezik:Slovenski jezik
Ključne besede:maligni plevralni izliv, plevrodeza, rastni faktorji, kakovost življenja


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