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Effectiveness of intraperitoneal or intrapleural administration of triamcinolone acetonide for the control of malignant ascites and pleural effusion (Kansai Clinical Oncology Group-G1102 study)


1 Department of Obstetrics and Gynecology, Kansai Rosai Hospital, Amagasaki, Japan
2 Department of Obstetrics and Gynecology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
3 Department of Obstetrics and Gynecology, Minoh City Hospital, Minoh, Osaka, Japan

Correspondence Address:
Kimihiko Ito,
Department of Obstetrics and Gynecology, Kansai Rosai Hospital, 3-1-69 Inabaso, Amagasaki, Hyogo 660-8511
Japan
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Source of Support: None, Conflict of Interest: None

Objectives: We conducted a retrospective multi-institutional study to evaluate the efficacy and toxicity of intraperitoneal or intrapleural triamcinolone acetonide (TA), a slowly metabolized corticosteroid administration for the management of malignant ascites or pleural effusion. Materials and Methods: The medical records of patients with gynecologic cancer who were treated with paracentesis or thoracocentesis followed by administration of 400 mg of TA between 2005 and 2014 were reviewed. Results: The median age of the 74 eligible patients was 59 years. An Eastern Cooperative Oncology Group performance status 3–4 was present in 53 patients (73%), and 52 patients (70%) had ovarian cancer. Paracentesis followed by TA administration was performed in 65 patients (88%), and 37 patients (50%) were treated in a palliative setting. Chemotherapy or surgery after TA administration was performed in 37 patients (50%) in an aggressive setting, of which 14 patients (19%) were treated at the primary phase and 23 patients (31%) were treated at recurrent phase. The time interval of serial drainage was prolonged in 15 of 19 assessable patients, resulting in a response rate of 79% (95% confidence interval [95% CI]: 54–94%). Median overall survival after TA therapy in a palliative setting was 36 days (95% CI: 19–58 days). After TA therapy in a palliative setting, one patient complained of mild abdominal pain, two patients with advanced peritonitis carcinomatosis experienced bowel perforation, and three patients died within 7 days owing to disease progression. Conclusions: Intraperitoneal and intrapleural TA administration were feasible and effective in symptomatic control of ascites and pleural effusion.


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