Quality of life after interventions for malignant pleural effusions: a systematic review.
pleural effusion
quality of life
talc pleurodesis
thoracoscopy
Journal
BMJ supportive & palliative care
ISSN: 2045-4368
Titre abrégé: BMJ Support Palliat Care
Pays: England
ID NLM: 101565123
Informations de publication
Date de publication:
Mar 2020
Mar 2020
Historique:
received:
19
07
2018
revised:
28
02
2019
accepted:
15
04
2019
pubmed:
28
6
2019
medline:
25
8
2020
entrez:
28
6
2019
Statut:
ppublish
Résumé
Malignant pleural effusion (MPE) results in breathlessness and impairment of health-related quality of life (HRQOL). This study reviews the existing literature on HRQOL following invasive interventions in MPE. Five electronic databases were systematically searched and assessed three times during the review process and last completed on 15 June 2018. We included all studies evaluating HRQOL outcomes for the following interventions: therapeutic thoracocentesis, talc slurry (TS) pleurodesis, indwelling pleural catheter (IPC) insertion and thoracoscopic talc poudrage (TTP) pleurodesis. Meta-analysis was not performed due to substantial heterogeneity in the published data. 17 studies were included in the review reporting HRQOL outcomes in 2515 patients. TTP, TS and IPC were associated with modest but inconsistent improvements in HRQOL up to 12 weeks. No intervention was significantly different from another in HRQOL outcomes at any time point. The attrition to follow-up was 48.3% (664/1374) at 3 months. The overall quality of studies was inadequate. TTP, TS and IPC seem to improve HRQOL in MPE over 4-12 weeks, but there are insufficient longer term data due to high attrition rates. Evidence on the most effective treatment strategy is limited by the small number of randomised or comparative studies. CRD42016051003.
Sections du résumé
BACKGROUND
BACKGROUND
Malignant pleural effusion (MPE) results in breathlessness and impairment of health-related quality of life (HRQOL). This study reviews the existing literature on HRQOL following invasive interventions in MPE.
METHODS
METHODS
Five electronic databases were systematically searched and assessed three times during the review process and last completed on 15 June 2018. We included all studies evaluating HRQOL outcomes for the following interventions: therapeutic thoracocentesis, talc slurry (TS) pleurodesis, indwelling pleural catheter (IPC) insertion and thoracoscopic talc poudrage (TTP) pleurodesis. Meta-analysis was not performed due to substantial heterogeneity in the published data.
RESULTS
RESULTS
17 studies were included in the review reporting HRQOL outcomes in 2515 patients. TTP, TS and IPC were associated with modest but inconsistent improvements in HRQOL up to 12 weeks. No intervention was significantly different from another in HRQOL outcomes at any time point. The attrition to follow-up was 48.3% (664/1374) at 3 months. The overall quality of studies was inadequate.
CONCLUSION
CONCLUSIONS
TTP, TS and IPC seem to improve HRQOL in MPE over 4-12 weeks, but there are insufficient longer term data due to high attrition rates. Evidence on the most effective treatment strategy is limited by the small number of randomised or comparative studies.
TRIAL REGISTRATION NUMBER
BACKGROUND
CRD42016051003.
Identifiants
pubmed: 31243020
pii: bmjspcare-2018-001610
doi: 10.1136/bmjspcare-2018-001610
doi:
Substances chimiques
Talc
14807-96-6
Types de publication
Journal Article
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
45-54Informations de copyright
© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.