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Review
. 2024 May 17;9(2):47-53.
doi: 10.1515/pp-2023-0048. eCollection 2024 Jun.

Review on treatment of pleural metastasis and malignant pleural effusion with Pressurized IntraThoracic Aerosol Chemotherapy (PITAC)

Pernille Schjødt Hansen  1 , Martin Graversen  1   2 , Sönke Detlefsen  1   3   4 , Michael Bau Mortensen  1   3   2
Affiliations
Review

Review on treatment of pleural metastasis and malignant pleural effusion with Pressurized IntraThoracic Aerosol Chemotherapy (PITAC)

Pernille Schjødt Hansen et al. Pleura Peritoneum. .

Abstract

Background: Malignant pleural effusion (MPE) is a common and debilitating condition seen in advanced cancer disease, and life-expectancy is short. Symptoms include pain and severe shortness of breath. Current first-line treatment options include pleural drainage using catheters as well as pleurodesis. However, these treatment modalities are often inefficient and patients need repeated procedures. Pressurized IntraThoracic Aerosol Chemotherapy (PITAC) is a minimally invasive procedure, where antineoplastic agents are nebulized under pressure into the pleural space.

Content: We present the preliminary safety, feasibility, and response assessment data for PITAC based on a comprehensive literature review.

Summary: Five retrospective studies reported data on 38 PITACs in 21 patients. Data were heterogeneous and incomplete on several important aspects such as procedure, safety, local effect and long-term outcomes. PITAC seems technically feasible with a low risk of complications and may provide some reduction in MPE in selected cases.

Outlook: PITAC seems feasible, but prospective phase I and II studies are needed to define safety, indications, and efficacy.

Keywords: cytoreductive surgery; malignant pleural effusion; malignant pleural mesothelioma; palliative treatment; pressurized intrathoracic aerosol chemotherapy.

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Conflict of interest statement

Competing interests: Authors state no conflict of interest.

References

    1. Semaan R, Feller-Kopman D, Slatore C, Sockrider M. Malignant pleural effusions. Am J Respir Crit Care Med. 2016;194:11–2. doi: 10.1164/rccm.1946P11. - DOI - PubMed
    1. Asciak R, Rahman NM. Malignant pleural effusion: from diagnostics to therapeutics. Clin Chest Med. 2018;39:181–93. doi: 10.1016/j.ccm.2017.11.004. - DOI - PubMed
    1. Bashour SI, Mankidy BJ, Lazarus DR. Update on the diagnosis and management of malignant pleural effusions. Respir Med. 2022;196:106802. doi: 10.1016/j.rmed.2022.106802. - DOI - PubMed
    1. Jonscher N, Hummels M, Giger-Pabst U, Karljalainen E, Zieren J, Büchner N, et al. Chapter 18 pressurized IntraThoracic aerosol chemotherapy (PITAC) In: Raymond MA, editor. The book of PIPAC - cancer under pressure. De Gruyter; 2014.
    1. Egan AM, McPhillips D, Sarkar S, Breen DP. Malignant pleural effusion. Qjm. 2014;107:179–84. doi: 10.1093/qjmed/hct245. - DOI - PubMed

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