Sclerosis of Pleural Effusions by Talc Thoracoscopy Versus Talc Slurry: A Phase III Study
OBJECTIVES: I. Compare the proportion of patients with successful pleurodesis at 30 days
following treatment for malignant pleural effusion (MPE) by talc slurry via chest tube vs
thoracoscopic talc insufflation. II. Compare the cost and cost effectiveness of both
treatments for MPE. III. Compare the time to recurrence of effusion, duration of chest tube
drainage after sclerosis, extent of postinstillation complications and toxicities, and the
ability to re-expand the lung in patients randomized to these 2 treatments. IV. Evaluate the
quality of life and pain experienced by patients during both treatments.
OUTLINE: This is a randomized study. Patients are stratified according to participating
institution. Patients are randomized to one of two treatment arms. Arm I: Patients undergo
pleurodesis. A chest tube is inserted, the pleural fluid is drained for 24 hours, and the
lung is re-expanded to at least 90% of full expansion. Within 24-36 hours patients undergo
sclerosis with talc slurry injected into the chest tube, which is then clamped. Patients are
rotated in all possible directions, holding each position for about 30 minutes. After 2
hours the chest tube is unclamped and reattached to suction drainage, which is strictly
measured for 24-hour totals. Following a decrease in drainage to no more than 150 ml/24
hours (usually by the second or third day postsclerosis), the chest tube is removed. Arm II:
Patients receive thoracoscopic insufflation. The chest is explored thoracoscopically via
single or multiple incisions using direct or videothoracoscopic visualization, and the lung
is re-expanded to 90% of full expansion. Dry talc is pneumatically insufflated into the
chest, with complete dispersion throughout the hemithorax. Following insufflation, the chest
is drained via a chest tube, which is removed when the drainage is no more than 150 ml/24
hours (usually by day 2 or 3 following insufflation). Patients are removed from study for
disease progression or an unsuccessful lung re-expansion. Patients are followed monthly for
6 months for relapse and survival.
PROJECTED ACCRUAL: Approximately 500 patients will be accrued for this study over 28 months.
Interventional
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Supportive Care
Successful pleurodesis
30 days
No
Jemi Olak, MD
Study Chair
Kern Medical Center
United States: Food and Drug Administration
CDR0000063982
NCT00002622
December 1994
January 2006
Name | Location |
---|---|
Akron City Hospital | Akron, Ohio 44304 |
Arizona Cancer Center | Tucson, Arizona 85724 |
Roswell Park Cancer Institute | Buffalo, New York 14263 |
Memorial Sloan-Kettering Cancer Center | New York, New York 10021 |
Albert Einstein Comprehensive Cancer Center | Bronx, New York 10461 |
University of Texas - MD Anderson Cancer Center | Houston, Texas 77030-4009 |
University of Michigan Comprehensive Cancer Center | Ann Arbor, Michigan 48109-0752 |
Kaplan Cancer Center | New York, New York 10016 |
Mayo Clinic Cancer Center | Rochester, Minnesota 55905 |
University of Alabama Comprehensive Cancer Center | Birmingham, Alabama 35294 |
Jonsson Comprehensive Cancer Center, UCLA | Los Angeles, California 90095-1781 |
USC/Norris Comprehensive Cancer Center | Los Angeles, California 90033-0800 |
University of Colorado Cancer Center | Denver, Colorado 80262 |
Walter Reed Army Medical Center | Washington, District of Columbia 20307-5000 |
H. Lee Moffitt Cancer Center and Research Institute | Tampa, Florida 33612 |
Emory University Hospital - Atlanta | Atlanta, Georgia 30322 |
University of Chicago Cancer Research Center | Chicago, Illinois 60637 |
University of Iowa Hospitals and Clinics | Iowa City, Iowa 52242 |
Albert B. Chandler Medical Center, University of Kentucky | Lexington, Kentucky 40536-0084 |
Johns Hopkins Oncology Center | Baltimore, Maryland 21287 |
CCOP - Ann Arbor Regional | Ann Arbor, Michigan 48106 |
Barbara Ann Karmanos Cancer Institute | Detroit, Michigan 48201 |
Cancer Center of Albany Medical Center | Albany, New York 12208 |
State University of New York Health Science Center at Brooklyn | Brooklyn, New York 11203 |
University of Rochester Cancer Center | Rochester, New York 14642 |
Lineberger Comprehensive Cancer Center, UNC | Chapel Hill, North Carolina 27599-7295 |
Comprehensive Cancer Center of Wake Forest University Baptist Medical Center | Winston-Salem, North Carolina 27157-1082 |
Ireland Cancer Center | Cleveland, Ohio 44106-5065 |
Arthur G. James Cancer Hospital - Ohio State University | Columbus, Ohio 43210 |
Kimmel Cancer Center of Thomas Jefferson University - Philadelphia | Philadelphia, Pennsylvania 19107 |
University of Pennsylvania Cancer Center | Philadelphia, Pennsylvania 19104 |
Fox Chase Cancer Center | Philadelphia, Pennsylvania 19111 |
Medical University of South Carolina | Charleston, South Carolina 29425-0721 |
CCOP - Upstate Carolina | Spartanburg, South Carolina 29303 |
Cancer Center, University of Virginia HSC | Charlottesville, Virginia 22908 |
St. Luke's Medical Center | Milwaukee, Wisconsin 53215 |
Sylvester Cancer Center, University of Miami | Miami, Florida 33136 |
CCOP - Wichita | Wichita, Kansas 67214-3882 |
MBCCOP - LSU Medical Center | New Orleans, Louisiana 70112 |
Hurley Medical Center | Flint, Michigan 48503 |
East Carolina University School of Medicine | Greenville, North Carolina 27858-4354 |
CCOP - Atlanta Regional | Atlanta, Georgia 30342-1701 |
CCOP - Kansas City | Kansas City, Missouri 64131 |
CCOP - Missouri Valley Cancer Consortium | Omaha, Nebraska 68131 |
CCOP - Southern Nevada Cancer Research Foundation | Las Vegas, Nevada 89106 |
CCOP - Baptist Cancer Institute | Memphis, Tennessee 38117 |
UCSF Cancer Center and Cancer Research Institute | San Francisco, California 94115-0128 |
CCOP - Christiana Care Health Services | Wilmington, Delaware 19899 |
CCOP - Mount Sinai Medical Center | Miami Beach, Florida 33140 |
Marlene & Stewart Greenebaum Cancer Center, University of Maryland | Baltimore, Maryland 21201 |
Ellis Fischel Cancer Center - Columbia | Columbia, Missouri 65203 |
Norris Cotton Cancer Center | Lebanon, New Hampshire 03756 |
CCOP - North Shore University Hospital | Manhasset, New York 11030 |
CCOP - Southeast Cancer Control Consortium | Winston-Salem, North Carolina 27104-4241 |
University of Tennessee, Memphis Cancer Center | Memphis, Tennessee 38103 |
CCOP - Carle Cancer Center | Urbana, Illinois 61801 |
CCOP - Iowa Oncology Research Association | Des Moines, Iowa 50309-1016 |
Beth Israel Deaconess Medical Center | Boston, Massachusetts 02215 |
CCOP - Kalamazoo | Kalamazoo, Michigan 49007-3731 |
CCOP - Metro-Minnesota | Saint Louis Park, Minnesota 55416 |
Veterans Affairs Medical Center - East Orange | East Orange, New Jersey 07018-1095 |
CCOP - Northern New Jersey | Hackensack, New Jersey 07601 |
University of Pittsburgh Cancer Institute | Pittsburgh, Pennsylvania 15213 |
Baptist Regional Cancer Center - Knoxville | Knoxville, Tennessee 37901 |
CCOP - Duluth | Duluth, Minnesota 55805 |
Vanderbilt Cancer Center | Nashville, Tennessee 37232-6838 |
MD Anderson Cancer Center Orlando | Orlando, Florida 32806 |
Loyola University Medical Center | Maywood, Illinois 60153 |
CCOP - Scottsdale Oncology Program | Scottsdale, Arizona 85259-5404 |
Siouxland Hematology-Oncology | Sioux City, Iowa 51101-1733 |
CCOP - Ochsner | New Orleans, Louisiana 70121 |
Massachusetts General Hospital Cancer Center | Boston, Massachusetts 02114 |
Quain & Ramstad Clinic, P.C. | Bismarck, North Dakota 58501 |
CCOP - Toledo Community Hospital Oncology Program | Toledo, Ohio 43623-3456 |
Rapid City Regional Hospital | Rapid City, South Dakota 57709 |
Henry Ford Hospital | Detroit, Michigan 48202 |
Marshfield Clinic | Marshfield, Wisconsin 54449 |
Medical College of Wisconsin | Milwaukee, Wisconsin 53226 |
Veterans Affairs Medical Center - Birmingham | Birmingham, Alabama 35233 |
Huntsville Hospital System | Huntsville, Alabama 35801 |
MBCCOP - University of South Alabama | Mobile, Alabama 36688 |
Urology Associates - Mobile AL | Mobile, Alabama 36640 |
Alabama Oncology, LLC | Montgomery, Alabama 36106-2801 |
Radiation Oncology Associates of West Alabama | Tuscallosa, Alabama 35401 |
Providence Cancer Therapy Center | Anchorage, Alaska 99508 |
Providence Saint Joseph Medical Center - Burbank | Burbank, California 91505 |
Mount Diablo Medical Center | Concord, California 94524-4110 |
California Cancer Center | Fresno, California 93720 |
Saint Agnes Cancer Center | Fresno, California 93720 |
Glendale Memorial Hospital and Health Center | Glendale, California 91204 |
Sutter Health Western Division Cancer Research Group | Greenbrae, California 94904 |
Loma Linda University Medical Center | Loma Linda, California 92354 |
Veterans Affairs Medical Center - Long Beach | Long Beach, California 90822 |
Kaiser Permanente Medical Center - Los Angeles | Los Angeles, California 90027 |
Beckman Research Institute, City of Hope | Los Angeles, California 91010 |
Veterans Affairs Outpatient Clinic - Martinez | Martinez, California 94553 |
CCOP - Bay Area Tumor Institute | Oakland, California 94609-3305 |
Cancer Care Center | Pomona, California 91767 |
Mercy Medical Center - Redding | Redding, California 96099-6009 |
Radiation Oncology Center - Sacramento | Sacramento, California 95816 |
Santa Cruz Radiation Oncology Medical Group, Inc. | Santa Cruz, California 95065 |
CCOP - Santa Rosa Memorial Hospital | Santa Rosa, California 95403 |
Stanford University | Stanford, California 94305 |
David Grant Medical Center | Travis Air Force Base, California 94535 |
Radiation Oncology Center - Walnut Creek | Walnut Creek, California 94598 |
Memorial Hospital Cancer Center | Colorado Springs, Colorado 80909 |
Bridgeport Hospital | Bridgeport, Connecticut 06610 |
Whittingham Cancer Center | Norwalk, Connecticut 06856 |
Lykes Center for Radiation Therapy | Clearwater, Florida 33757-0210 |
Halifax Medical Center | Daytona Beach, Florida 32114 |
Radiation Therapy Associates - Fort Myers | Fort Myers, Florida 33901 |
University of Florida Health Science Center | Gainesville, Florida 32610-0296 |
Health First Holmes Regional Medical Center | Melbourne, Florida 32901 |
Baptist Hospital of Miami | Miami, Florida 33176-2197 |
Florida Radiation Oncology Group | Orange Park, Florida 32073 |
Gulf Coast Cancer Treatment Center | Panama City, Florida 32405-4587 |
West Florida Cancer Institute - Pensacola | Pensacola, Florida 32514 |
Bayfront Medical Center | Saint Petersburg, Florida 33701 |
InterCommunity Cancer Center at Rome | Rome, Georgia 30161 |
South Georgia Medical Center | Valdosta, Georgia 31603 |
Northwestern Memorial Hospital | Chicago, Illinois 60611 |
Ingalls Memorial Hospital | Harvey, Illinois 60426 |
Lutheran General Cancer Care Center | Park Ridge, Illinois 60068 |
Methodist Medical Center of Illinois | Peoria, Illinois 61636 |
CCOP - Central Illinois | Springfield, Illinois 62526 |
St. John's Medical Center | Anderson, Indiana 46016 |
Clarion Health Partners Inc. | Indianapolis, Indiana 46206-1367 |
Community Hospitals of Indianapolis - Regional Cancer Center | Indianapolis, Indiana 46219 |
Ball Memorial Hospital | Muncie, Indiana 47303-3499 |
Memorial Hospital of South Bend | South Bend, Indiana 46601 |
St. Joseph's Radiation Oncology Center | South Bend, Indiana 46617 |
Wendt Regional Cancer Center of Finley Hospital | Dubuque, Iowa 52001 |
Medical Center at Bowling Green | Bowling Green, Kentucky 42102 |
Veterans Affairs Medical Center - Lexington | Lexington, Kentucky 40511-1093 |
James Graham Brown Cancer Center | Louisville, Kentucky 40202 |
Louisville Radiation Oncology | Louisville, Kentucky 40215 |
Merle M. Mahr Cancer Center | Madisonville, Kentucky 42431 |
Western Baptist Hospital | Paducah, Kentucky 42001 |
Mary Bird Perkins Cancer Center | Baton Rouge, Louisiana 70809 |
Romagosa Radiation Oncology Center | Lafayette, Louisiana 70501 |
East Jefferson General Hospital | Metairie, Louisiana 70011 |
Maine Medical Center | Portland, Maine 04102 |
Anne Arundel Oncology Center | Annapolis, Maryland 21401 |
Greater Baltimore Medical Center and Cancer Center | Baltimore, Maryland 21204 |
Harbor Hospital Center | Baltimore, Maryland 21225 |
Radiation Oncology Affiliates of Maryland, P.A. | Baltimore, Maryland 21237 |
Joint Center for Radiation Therapy | Boston, Massachusetts 02215 |
Cape Cod Hospital | Hyannis, Massachusetts 02601 |
Veterans Affairs Medical Center - Ann Arbor | Ann Arbor, Michigan 48105 |
Marquette General Hospital | Marquette, Michigan 49855 |
St. Mary's Medical Center | Saginaw, Michigan 48601 |
Veterans Affairs Medical Center - Saint Louis | Saint Louis, Missouri 63106 |
Mallinckrodt Institute of Radiology | Saint Louis, Missouri 63110 |
St. Louis University Health Sciences Center | Saint Louis, Missouri 63110-0250 |
Cancer Research for the Ozarks | Springfield, Missouri 65807 |
CCOP - Montana Cancer Consortium | Billings, Montana 59101 |
Methodist Cancer Center - Omaha | Omaha, Nebraska 68114 |
Elliot Regional Cancer Center | Manchester, New Hampshire 03103 |
John F. Kennedy Medical Center | Edison, New Jersey 08818 |
South Jersey Hospital - Millville | Millville, New Jersey 08332 |
Fox Chase Cancer Center at Virtua-Memorial Hospital Burlington County | Mount Holly, New Jersey 08060 |
Community Medical Center | Toms River, New Jersey 08755 |
St. Francis Medical Center | Trenton, New Jersey 08629 |
Saint Joseph Medical Center | Albuquerque, New Mexico 87102 |
Veterans Affairs Medical Center - Albany | Albany, New York 12208 |
New York Methodist Hospital | Brooklyn, New York 11215-3609 |
Champlain Valley Physicians Hospital Medical Center | Plattsburgh, New York 12901 |
Vassar Brothers Hospital | Poughkeepsie, New York 12601 |
Genesee Hospital - Rochester | Rochester, New York 14607 |
New York Medical College | Valhalla, New York 10595 |
Meritcare Roger Maris Cancer Center | Fargo, North Dakota 58122 |
UNI-MED Medical Center | Minot, North Dakota 58701 |
Akron General Medical Center | Akron, Ohio 44302 |
Christ Hospital | Cincinnati, Ohio 45219 |
CCOP - Columbus | Columbus, Ohio 43206 |
Veterans Affairs Medical Center - Dayton | Dayton, Ohio 45428 |
CCOP - Dayton | Kettering, Ohio 45429 |
St. John Medical Center | Tulsa, Oklahoma 74104 |
Samaritan Regional Cancer Center | Corvallis, Oregon 97339 |
CCOP - Columbia River Program | Portland, Oregon 97213 |
Penn State Geisinger Medical Center | Danville, Pennsylvania 17822-2001 |
Mercy Catholic Medical Center, Mercy Fitzgerald Divison | Darby, Pennsylvania 19023 |
Delaware County Memorial Hospital | Drexel Hill, Pennsylvania 19026 |
Penn State Geisinger Cancer Center | Hershey, Pennsylvania 17033 |
Allegheny University Hospitals- Hahnemann | Philadelphia, Pennsylvania 19102-1192 |
Albert Einstein Cancer Center | Philadelphia, Pennsylvania 19141 |
Veterans Affairs Medical Center - Philadelphia | Philadelphia, Pennsylvania 19104 |
Western Pennsylvania Hospital | Pittsburgh, Pennsylvania 15224 |
Reading Hospital and Medical Center | Reading, Pennsylvania 19612-6052 |
Mercy Hospital Cancer Center - Scranton | Scranton, Pennsylvania 18501 |
Grand View Hospital | Sellersville, Pennsylvania 18960 |
Wilkes Barre General Hospital | Wilkes-Barre, Pennsylvania 18764 |
CCOP - MainLine Health | Wynnewood, Pennsylvania 19096 |
York Hospital | York, Pennsylvania 17315 |
CCOP - Greenville | Greenville, South Carolina 29615 |
Jackson-Madison County General Hospital | Jackson, Tennessee 38301 |
Julie and Ben Rogers Cancer Institute | Beaumont, Texas 77701 |
University of Texas Medical Branch | Galveston, Texas 77555-1329 |
Wilford Hall - 59th Medical Wing | Lackland Air Force Base, Texas 78236-5300 |
Bayshore Medical Center | Pasadena, Texas 77504 |
Dixie Regional Medical Center | Saint George, Utah 84770 |
LDS Hospital | Salt Lake City, Utah 84143 |
Green Mountain Oncology Group | Rutland, Vermont 05701 |
Veterans Affairs Medical Center - White River Junction | White River Junction, Vermont 05009 |
Martha Jefferson Hospital | Charlottesville, Virginia 22901 |
Virginia Baptist Hospital | Lynchburg, Virginia 24503 |
Naval Medical Center, Portsmouth | Portsmouth, Virginia 23708-2197 |
Massey Cancer Center | Richmond, Virginia 23298-0037 |
Virginia Mason Medical Center | Seattle, Washington 98111 |
Deaconess Medical Center | Spokane, Washington 99210-0248 |
Yakima Valley Memorial Hospital | Yakima, Washington 98902 |
Schiffler Oncology Center | Wheeling, West Virginia 26003 |
St. Vincent Hospital | Green Bay, Wisconsin 54307-3508 |
Gundersen Lutheran Medical Foundation | La Crosse, Wisconsin 54601 |
Veterans Affairs Medical Center - Madison | Madison, Wisconsin 53705 |
University of Wisconsin Comprehensive Cancer Center | Madison, Wisconsin 53792 |
Southern Wisconsin Radiotherapy Center | Madison, Wisconsin 53713 |
Community Memorial Hospital | Menomonee Falls, Wisconsin 53051 |
Columbia Hospital | Milwaukee, Wisconsin 53211 |
St. Joseph's Hospital | Milwaukee, Wisconsin 53210 |
Veterans Affairs Medical Center - Milwaukee (Zablocki) | Milwaukee, Wisconsin 53295 |
Southeastern Wisconsin Regional Cancer Center | Racine, Wisconsin 53405 |
Elizabeth General Medical Center - West | Elizabeth, New Jersey 07201 |
Swedish Hospital Tumor Institute | Seattle, Washington 98104 |