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Title   악성 복수 및 흉수에 대한 166 Holmium - chitosan 복합체의 체강내 치료 ( Intracavitary 166 Holmium - chitosan Complex Therapy in Patients with Malignant Peritoneal or Pleural Effusions )
Publicationinfo   1999 Jan; 031(06): 1307-1315.
Key_word   166Ho-CHICO, Malignant effusions
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Abstract   Purpose: Most malignant peritoneal or pleural effusions caused by advanced malignancy are unresponsive to systemic chemotherapy except for chemotherapy sensitive tumors, and they are equally ineffective to regional therapy or radiotherapy. Thus, for the purpose of palliating the symptoms related to malignant effusion and to reduce fluid reaccumulations, we evaluated the therapeutic feasibility and efficacy of intracavitary ' Ho-CHICO (chito- san complex) instillation for intractable malignant effusions Materials and Methods: Thirty one patients with cytologically or pathologically proven malignant effusions underwent intracavitary 166Ho-CHICO therapy from May 1996 to March 1998 at Ajou University Hospital. The subjective and objective responses were evaluated 4 weeks after the treatment, including the changes of symptoms, weight, abdomi- nal girth, doses of diuretics, frequencies and amounts of repeat aspirations for fluid reaccumulations, and imaging studies of chest radiograph and ultrasounds. Results: The response rates treated with Ho-CHICO were 50% in patients with peri- toneal effusion and 46% in patients with pleural effusion (overall 49%). The response rates between 166Ho-CHICO doses of 50-80 mCi and 90-100 mCi were similar (50% vs 47%). Response rate of 70% was noted in patients with even distribution of radioisotope on the post-therapy scan, but, the response rate was lower in cases with focal (44%) and uneven (29%) distribution pattern. There was no difference in response by the effusion sites. All patients tolerated intracavitary 166Ho-CHICO instillation well, although the ma- jority of patients experienced Grade I/II side effects such as pain, fever, weakness and dyspnea. But, no serious complications of Grade lII or IV degree were observed with 166Ho-CHICO therapy. Conclusion: Intracavitary 166Ho-CHICO instillation was clinically efficacious in control- ling malignant effusions without a significant toxicity seen with conventional sclerotic therapy. The therapeutic modality appeared to offer similar benefits obtained with the conventional intracavitary therapy.
저 자   조도연(Do Yeun Cho),김현수(Hyun Soo Kim),박준성(Joon Seong Park),정철권(Cheol Kweon Jeong),최진혁(Jin Hyuk Choi),임호영(Ho Yeong Lim),박찬희(Chan Hee Park),전미선(Mi Son Chun),김영미(Young Mi Kim),박경배(Kyung Bae Park),김효철(Hugh Chul Kim)