Journal of the National Comprehensive Cancer Network : JNCCN
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J Natl Compr Canc Netw · Aug 2012
Randomized Controlled Trial Multicenter StudyOptimal management of malignant pleural effusions (results of CALGB 30102).
The optimal strategy to achieve palliation of malignant pleural effusions (MPEs) is unknown. This multi-institutional, prospective, randomized trial compares 2 established methods for controlling symptomatic unilateral MPEs. Patients with unilateral MPEs were randomized to either daily tunneled catheter drainage (TCD) or bedside talc pleurodesis (TP). ⋯ Multivariate regression analysis revealed that patients treated with TCD had better 30-day activity without dyspnea scores (8.7 vs. 5.9; P = .036), especially in the subgroup with impaired expansion (9.1 vs. 4.6; P = .042). Patients who underwent TCD had better survival with effusion control at 30 days compared with those who underwent TP (82% vs. 52%, respectively; P = .024). In this prospective randomized trial, TCD achieved superior palliation of unilateral MPEs than TP, particularly in patients with trapped lungs.
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J Natl Compr Canc Netw · Aug 2012
Historical ArticleRandomized controlled trials and 21st century epistemology.