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. 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. 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. 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.
Ye et al. (Thu,) studied this question.