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Background <p>Malignant pleural effusion (MPE) is a common and serious manifestation of advanced non-small cell lung cancer (NSCLC). This study aimed to retrospectively evaluate the efficacy and safety of thoracoscopic photodynamic therapy (PDT) combined with 5% ethanol-cisplatin intrapleural perfusion compared to cisplatin intrapleural perfusion or drainage alone.</p> Methods <p>This retrospective study analyzed 122 NSCLC patients with MPE who had failed first-line chemotherapy. Patients were divided into three groups: PDT combined with 5% ethanol-cisplatin (PDT + E-Cis, <i>n</i> = 32), intrapleural cisplatin perfusion (IP-Cis, <i>n</i> = 39), and drainage alone control (Control, <i>n</i> = 51). All patients received systemic chemotherapy with docetaxel. Observation endpoints included overall survival (OS), progression-free survival (PFS), overall response rate (ORR), and safety.</p> Results <p>At week 12, the ORR of the PDT + E-Cis group was 75.0%, significantly higher than that of the IP-Cis group (43.6%) and the Control group (17.6%) (All <i>P</i> &lt; 0.05). Survival analysis showed that the median PFS of the PDT + E-Cis group (6.13 months) was significantly longer than that of the Control group (3.48 months, <i>P</i> = 0.005), but showed no statistical difference compared to the IP-Cis group (4.21 months, <i>P</i> = 0.229). The median OS (14.17 months) was significantly superior to that of the Control group (8.88 months, <i>P</i> &lt; 0.001) and showed a trend towards prolongation compared to the IP-Cis group (11.23 months, <i>P</i> = 0.033). Regarding safety, the incidence of chest pain and fever in the PDT + E-Cis group was higher than in the Control group but similar to the IP-Cis group. Most adverse events were grade 1–2, with no treatment-related deaths or severe adverse events occurring.</p> Conclusion <p>Thoracoscopic PDT combined with 5% ethanol-cisplatin intrapleural perfusion demonstrates favorable safety and efficacy. It can significantly improve the local control rate of MPE in NSCLC and shows clinical potential for prolonging patient survival.</p>

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Efficacy and safety of thoracoscopic photodynamic therapy combined with 5% ethanol–cisplatin intrapleural perfusion in the treatment of malignant pleural effusion in non-small cell lung cancer

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月2日

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  • Lijing Ye,
  • Lejing Lou,
  • Zhangyong Yin,
  • Ting He,
  • Xiaoping Cai

摘要

Background

Malignant pleural effusion (MPE) is a common and serious manifestation of advanced non-small cell lung cancer (NSCLC). This study aimed to retrospectively evaluate the efficacy and safety of thoracoscopic photodynamic therapy (PDT) combined with 5% ethanol-cisplatin intrapleural perfusion compared to cisplatin intrapleural perfusion or drainage alone.

Methods

This retrospective study analyzed 122 NSCLC patients with MPE who had failed first-line chemotherapy. Patients were divided into three groups: PDT combined with 5% ethanol-cisplatin (PDT + E-Cis, n = 32), intrapleural cisplatin perfusion (IP-Cis, n = 39), and drainage alone control (Control, n = 51). All patients received systemic chemotherapy with docetaxel. Observation endpoints included overall survival (OS), progression-free survival (PFS), overall response rate (ORR), and safety.

Results

At week 12, the ORR of the PDT + E-Cis group was 75.0%, significantly higher than that of the IP-Cis group (43.6%) and the Control group (17.6%) (All P < 0.05). Survival analysis showed that the median PFS of the PDT + E-Cis group (6.13 months) was significantly longer than that of the Control group (3.48 months, P = 0.005), but showed no statistical difference compared to the IP-Cis group (4.21 months, P = 0.229). The median OS (14.17 months) was significantly superior to that of the Control group (8.88 months, P < 0.001) and showed a trend towards prolongation compared to the IP-Cis group (11.23 months, P = 0.033). Regarding safety, the incidence of chest pain and fever in the PDT + E-Cis group was higher than in the Control group but similar to the IP-Cis group. Most adverse events were grade 1–2, with no treatment-related deaths or severe adverse events occurring.

Conclusion

Thoracoscopic PDT combined with 5% ethanol-cisplatin intrapleural perfusion demonstrates favorable safety and efficacy. It can significantly improve the local control rate of MPE in NSCLC and shows clinical potential for prolonging patient survival.