Efficacy and safety of endostar intracavitary infusion in treatment of malignant serous cavity effusion: A case control study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHANG Shuling , MA Jietao , ZHAO Jianzhu , SUN Li , JING Wei , ZHOU Yang , HUANG Letian ,  HAN Chengbo

First Department of Oncology, Shengjing Hospital, China Medical University, Shenyang, 110022, P.R.China;

Corresponding author：

HAN Chengbo, Email: hanchengbo@sj-hospital.org

Keywords：

Endostar; carboplatin; malignant serous cavity effusion; intracavitary infusion

DOI：

10.7507/1007-4848.201701015

Video：

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Objective To analyze the clinical efficacy and safety of endostar or carboplatin combined with endostar intracavitary perfusion in the treatment of malignant serous cavity effusion. Methods We retrospectively reviewed the clinical data of 78 cancer patients with malignant serous cavity effusion who received paracentesis and intracavitary endostar, or carboplatin combined with endostar in Shengjing Hospital of China Medical University between November 2011 and November 2016. There were 42 males and 36 females at a median age of 62 years ranging from 17 to 78 years. According to treatment methods, 78 patients were divided into two groups, in which 33 patients received intracavitary endostar combined with carboplatin (a combination group, 15 males and 18 females at a median age of 56 years ranging from 17 to 66 years), and 45 patients received intracavitary endostar (an endostar group, 27 males and 18 females at a median age of 63 years ranging from 38 to 78 years). The efficacy and safety of two methods were analyzed and compared. Results The response rate in the combination group was 75.8%, which was higher than that in the endostar group (60.0%, P=0.035). In quality of life improvement, there was no statistical difference between the two groups (P=0.113). The incidence of fatigue, myelosuppression and gastrointestinal reactions in the endostar group was significantly lower than that of the combination group (P=0.006, 0.000 and 0.017, respectively). Analysis of long-term efficacy revealed that the median time to progress (TTP) in the combination group and endostar group was 171 days and 143 days, respectively (P=0.030). Conclusion Intracavitary infusion of endostar alone, or carboplatin combined with endostar is effective and tolerable for controlling malignant serous cavity effusion. But for the patients with poor physical state who can not tolerant platinum perfusion, intracavitary infusion of endostar alone can be adopted to control malignant serous cavity effusion.

Citation： ZHANG Shuling, MA Jietao, ZHAO Jianzhu, SUN Li, JING Wei, ZHOU Yang, HUANG Letian, HAN Chengbo. Efficacy and safety of endostar intracavitary infusion in treatment of malignant serous cavity effusion: A case control study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2018, 25(2): 138-142. doi: 10.7507/1007-4848.201701015 Copy

1.	Figlin R, Mendoza E, Piantadosi S, et al. Intrapleural chemotherapy without pleurodesis for malignant pleural effusions. LCSG Trial 861. Chest, 1994, 106(6 Suppl): 363S-366S.
2.	Ayantunde AA, Parsons SL. Pattern and prognostic factors in patients with malignant ascites: a retrospective study. Ann Oncol, 2007, 18(5): 945-949.
3.	Martínez-Moragón E, Aparicio J, Sanchis J, et al. Malignant pleural effusion: prognostic factors for survival and response to chemical pleurodesis in a series of 120 cases. Respiration, 1998, 65(2): 108-113.
4.	Heffner JE, Klein JS. Recent advances in the diagnosis and management of malignant pleural effusions. Mayo Clin Proc, 2008, 83(2): 235-250.
5.	Chen D, Li X, Zhao H, et al. The efficacy of pemetrexed and bevacizumab intrapleural injection for malignant pleural mesothelioma-mediated malignant pleural effusion. Indian J Cancer, 2014, 51 Suppl 3: e82-e85.
6.	Tamiya M, Tamiya A, Yamadori T, et al. Phase2 study of bevacizumab with carboplatin-paclitaxel for non-small cell lung cancer with malignant pleural effusion. Med Oncol, 2013, 30(3): 676.
7.	Pichelmayer O, Gruenberger B, Zielinski C, et al. Bevacizumab is active in malignant effusion. Ann Oncol, 2006, 17(12): 1853.
8.	胡兴胜, 王宏羽, 张长弓, 等. 重组人血管内皮抑素联合顺铂腔内化疗治疗恶性胸腔积液的临床研究. 临床药物治疗杂, 2015, 13(3): 23-27.
9.	帖晓静, 徐志巧, 徐月, 等. 重组人血管内皮抑素联合奈达铂腹腔热灌注化疗治疗消化道肿瘤并恶性腹腔积液疗效观察. 中华实用诊断与治疗杂志, 2016, 30(4): 412-414.
10.	Xue SL, Deng X, Liu Y, et al. Intraperitoneal recombinant human endostatin combined with chemotherapy for refractory malignant ascites due to gastrointestinal cancer: a pilot study. Hepatogastroenterology, 2013, 60(121): 118-123.
11.	Zhao WY, Chen DY, Chen JH, et al. Effects of intracavitary administration of Endostar combined with cisplatin in malignant pleural effusion and ascites. Cell Biochem Biophys, 2014, 70(1): 623-628.
12.	Chen WJ, Yuan SF, Yan QY, et al. Intrapleural chemo- and hyperthermotherapies for malignant pleural effusion: a randomized prospective study. Cancer Invest, 2012, 30(2): 126-130.
13.	Becker G, Galandi D, Blum HE. Malignant ascites: systematic review and guideline for treatment. Eur J Cancer, 2006, 42(5): 589-597.
14.	Hooper CE, Elvers KT, Welsh GI, et al. VEGF and sVEGFR-1 in malignant pleural effusions: association with survival and pleurodesis outcomes. Lung Cancer, 2012, 77(2): 443-449.
15.	Wheate NJ, Walker S, Craig GE, et al. The status of platinum anticancer drugs in the clinic and in clinical trials. Dalton Trans, 2010, 39(35): 8113-8127.
16.	Tamsma JT, Keizer HJ, Meinders AE. Pathogenesis of malignant ascites: Starling's law of capillary hemodynamics revisited. Ann Oncol, 2001, 12(10): 1353-1357.
17.	Hanai J, Gloy J, Karumanchi SA, et al. Endostatin is a potential inhibitor of Wnt signaling. J Cell Biol, 2002, 158(3): 529-539.
18.	MacDonald NJ, Shivers WY, Narum DL, et al. Endostatin binds tropomyosin. A potential modulator of the antitumor activity of endostatin. J Biol Chem, 2001, 276(27): 25190-25196.
19.	Kim YM, Hwang S, Kim YM, et al. Endostatin blocks vascular endothelial growth factor-mediated signaling via direct interaction with KDR/Flk-1. J Biol Chem, 2002, 277(31): 27872-27879.
20.	谢海英. 恩度联合铂类药物腔内灌注治疗恶性浆膜腔积液随机对照试验的meta分析. 广西医科大学, 2015, 33(22): 263-265.
21.	Qin S, Cheng Y, Tan Q, et al. Recombinant human endostatin and/or cisplatin in treatment of malignant hydrothorax and ascites: a multicenter randomized study. J Thora Oncol, 2017, (12(S1)): S530-S531.
22.	陈凤, 李全福, 金高娃, 等. 重组人血管内皮抑制素联合顺铂胸腔灌注治疗非小细胞肺癌恶性胸腔积液的疗效观察. 中国癌症防治杂志, 2016, 8(4): 246-249.
23.	郭加友, 方立俭, 郭嘉漪. 浆膜腔灌注恩度联合顺铂用于恶性浆膜腔积液的临床观察. 中国医学创新, 2016, (4):68-71.
24.	陈瑞琳, 张程程, 吴桦, 等. 重组人血管内皮抑制素注射液联合顺铂注射液胸腔灌注治疗晚期非小细胞肺癌恶性胸腔积液的临床疗效观察. 实用心脑肺血管病杂志, 2016, 24(5): 118-120.
25.	卢筠, 谢强, 陈群, 等. 重组人血管内皮抑素联合顺铂胸腔内注射治疗肺腺癌恶性胸腔积液的临床研究. 临床肺科杂志, 2016, 21(9): 1664-1667.

1. Figlin R, Mendoza E, Piantadosi S, et al. Intrapleural chemotherapy without pleurodesis for malignant pleural effusions. LCSG Trial 861. Chest, 1994, 106(6 Suppl): 363S-366S.
2. Ayantunde AA, Parsons SL. Pattern and prognostic factors in patients with malignant ascites: a retrospective study. Ann Oncol, 2007, 18(5): 945-949.
3. Martínez-Moragón E, Aparicio J, Sanchis J, et al. Malignant pleural effusion: prognostic factors for survival and response to chemical pleurodesis in a series of 120 cases. Respiration, 1998, 65(2): 108-113.
4. Heffner JE, Klein JS. Recent advances in the diagnosis and management of malignant pleural effusions. Mayo Clin Proc, 2008, 83(2): 235-250.
5. Chen D, Li X, Zhao H, et al. The efficacy of pemetrexed and bevacizumab intrapleural injection for malignant pleural mesothelioma-mediated malignant pleural effusion. Indian J Cancer, 2014, 51 Suppl 3: e82-e85.
6. Tamiya M, Tamiya A, Yamadori T, et al. Phase2 study of bevacizumab with carboplatin-paclitaxel for non-small cell lung cancer with malignant pleural effusion. Med Oncol, 2013, 30(3): 676.
7. Pichelmayer O, Gruenberger B, Zielinski C, et al. Bevacizumab is active in malignant effusion. Ann Oncol, 2006, 17(12): 1853.
8. 胡兴胜, 王宏羽, 张长弓, 等. 重组人血管内皮抑素联合顺铂腔内化疗治疗恶性胸腔积液的临床研究. 临床药物治疗杂, 2015, 13(3): 23-27.
9. 帖晓静, 徐志巧, 徐月, 等. 重组人血管内皮抑素联合奈达铂腹腔热灌注化疗治疗消化道肿瘤并恶性腹腔积液疗效观察. 中华实用诊断与治疗杂志, 2016, 30(4): 412-414.
10. Xue SL, Deng X, Liu Y, et al. Intraperitoneal recombinant human endostatin combined with chemotherapy for refractory malignant ascites due to gastrointestinal cancer: a pilot study. Hepatogastroenterology, 2013, 60(121): 118-123.
11. Zhao WY, Chen DY, Chen JH, et al. Effects of intracavitary administration of Endostar combined with cisplatin in malignant pleural effusion and ascites. Cell Biochem Biophys, 2014, 70(1): 623-628.
12. Chen WJ, Yuan SF, Yan QY, et al. Intrapleural chemo- and hyperthermotherapies for malignant pleural effusion: a randomized prospective study. Cancer Invest, 2012, 30(2): 126-130.
13. Becker G, Galandi D, Blum HE. Malignant ascites: systematic review and guideline for treatment. Eur J Cancer, 2006, 42(5): 589-597.
14. Hooper CE, Elvers KT, Welsh GI, et al. VEGF and sVEGFR-1 in malignant pleural effusions: association with survival and pleurodesis outcomes. Lung Cancer, 2012, 77(2): 443-449.
15. Wheate NJ, Walker S, Craig GE, et al. The status of platinum anticancer drugs in the clinic and in clinical trials. Dalton Trans, 2010, 39(35): 8113-8127.
16. Tamsma JT, Keizer HJ, Meinders AE. Pathogenesis of malignant ascites: Starling's law of capillary hemodynamics revisited. Ann Oncol, 2001, 12(10): 1353-1357.
17. Hanai J, Gloy J, Karumanchi SA, et al. Endostatin is a potential inhibitor of Wnt signaling. J Cell Biol, 2002, 158(3): 529-539.
18. MacDonald NJ, Shivers WY, Narum DL, et al. Endostatin binds tropomyosin. A potential modulator of the antitumor activity of endostatin. J Biol Chem, 2001, 276(27): 25190-25196.
19. Kim YM, Hwang S, Kim YM, et al. Endostatin blocks vascular endothelial growth factor-mediated signaling via direct interaction with KDR/Flk-1. J Biol Chem, 2002, 277(31): 27872-27879.
20. 谢海英. 恩度联合铂类药物腔内灌注治疗恶性浆膜腔积液随机对照试验的meta分析. 广西医科大学, 2015, 33(22): 263-265.
21. Qin S, Cheng Y, Tan Q, et al. Recombinant human endostatin and/or cisplatin in treatment of malignant hydrothorax and ascites: a multicenter randomized study. J Thora Oncol, 2017, (12(S1)): S530-S531.
22. 陈凤, 李全福, 金高娃, 等. 重组人血管内皮抑制素联合顺铂胸腔灌注治疗非小细胞肺癌恶性胸腔积液的疗效观察. 中国癌症防治杂志, 2016, 8(4): 246-249.
23. 郭加友, 方立俭, 郭嘉漪. 浆膜腔灌注恩度联合顺铂用于恶性浆膜腔积液的临床观察. 中国医学创新, 2016, (4):68-71.
24. 陈瑞琳, 张程程, 吴桦, 等. 重组人血管内皮抑制素注射液联合顺铂注射液胸腔灌注治疗晚期非小细胞肺癌恶性胸腔积液的临床疗效观察. 实用心脑肺血管病杂志, 2016, 24(5): 118-120.
25. 卢筠, 谢强, 陈群, 等. 重组人血管内皮抑素联合顺铂胸腔内注射治疗肺腺癌恶性胸腔积液的临床研究. 临床肺科杂志, 2016, 21(9): 1664-1667.

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Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Efficacy and safety of endostar intracavitary infusion in treatment of malignant serous cavity effusion: A case control study

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