Usefulness of cell-free and concentrated pleural effusion reinfusion therapy in terminal cancer patients.

OBJECTIVE

Patients with advanced or recurrent cancer often suffer from excessive fluid retention, which substantially affects their quality of life. There are no detailed reports regarding cell-free and concentrated pleural effusion reinfusion therapy (CPRT). Thus, we investigated the usefulness of CPRT for pleural effusions in terminal cancer patients.

METHODS

We evaluated the efficacy and complications of CPRT in 29 patients treated at Fujita Health University Nanakuri Memorial Hospital between April 2016 and August 2020. Nutritional status before and after CPRT was evaluated by measuring serum albumin (Alb) and transthyretin (TTR) levels as indicators. Clinical symptoms were assessed to evaluate the following nine items: pain, general fatigue, anorexia, dyspnea, depression, nausea, insomnia, constipation, and dry mouth.

RESULTS

CPRT was performed a total of 71 times, with a median of one session per patient. Median volume of drained pleural fluid was 800 mL, and the median volume of reinfused fluid was 120 mL. Regarding nutritional status before and after CPRT, serum Alb and TTR values did not decrease significantly and were maintained. Clinical symptoms showed a tendency toward improvement; dyspnea, depression, and insomnia improved significantly.No correlation was observed between the volume of pleural fluid drainage and the reduction of dyspnea, but there was a mild correlation with general fatigue and nausea. Conversely, constipation was mildly inversely correlated with the volume of pleural fluid drainage.

CONCLUSION

CPRT for pleural effusions in patients with terminal cancer was suggested to maintain nutritional status and may be useful in improving clinical symptom.