Introduction and objectives Indwelling pleural catheters (IPC) are well established in the management of malignant pleural effusions. However, there is some reluctance in its use in patients receiving chemotherapy due to a hypothetical increased risk of infection. There are no prospective trials primarily examining IPC safety in chemotherapy. Retrospective series suggest a similar IPC-related complication rate in chemotherapy and non-chemotherapy patients.1,2 Our primary study objective is to determine the safety of IPC insertion in chemotherapy.
Methods We conducted a retrospective analysis of all patients who underwent IPC insertion for malignant pleural effusion at our trust from September 2010 to December 2014. Data was collected on IPC insertion and removal, tumour type, systemic chemotherapy, pleural infection and other complications.
Results 104 patients were identified, (Table 1) 43 in chemotherapy group and 61 in non-chemotherapy group. The incidence of pleural infection in chemotherapy group vs non-chemotherapy group, 4 (9.3%) vs 4 (6.5%) respectively, was not statistically different (Fisher’s exact p = 0.4). There was no significant difference in 6-month infection-free duration from the date of IPC insertion (log rank p = 0.6). Overall 6-month mortality in chemotherapy group was significantly lower than in non-chemotherapy group (log rank p = 0.007).
Conclusions This is the second largest retrospective case-control series which concludes that systemic chemotherapy is safe in patients with indwelling pleural catheters.
References 1 Mekhaiel E, Kashyap R, Mullon JJ, et al. Infections associated with tunnelled indwelling pleural catheters in patients undergoing chemotherapy. J Bronchology Interv Pulmonol. 2013;20(4):299–303
2 Morel A, Mishra E, Medley L, et al. Chemotherapy should not be withheld from patients with an indwelling pleural catheter for malignant pleural effusion. Thorax 2011;66(5):448–9
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