Intrapleural treatment in patients with non-small cell lung cancer with malignant pleural effusions in the real world.

BACKGROUND: The aim of the study was to assess the efficacy and side-effects of intrapleural treatment in non-small cell lung cancer (NSCLC) patients with malignant pleural effusions (MPEs). METHODS: The medical records of NSCLC patients with MPEs diagnosed in four Chinese hospitals from October 2014 to December 2019 were searched. The Kaplan-Meier method is used to calculate median overall survival (MOS) and subgroup analyses are done. RESULTS: A total of 285 patients were evaluated; 81.1% of patients received intrapleural treatment, and no patients received talc pleurodesis. MOS of the whole cohort was 21 months. Patients were divided into three groups: erythromycin group (EG; intrapleural treatment with drugs and erythromycin); intrathoracic treatment group (ITG; intrapleural treatment with drugs); control group (CG; no drug treatment in the pleural cavity). The MOS of patients in the EG, ITG and CG was 20, 22, and 19 months, respectively. Among patients who received only chemotherapy as systemic therapy, the MOS of intrathoracic administration group (IAG; i.e., EG and ITG) was longer than that of CG (12 vs. 6 months; p = 0.034), and the MOS of patients with a ratio of carcinoembryonic antigen in pleural effusion (PE-CEA): CEA in blood (B-CEA) ≤1 is worse than that of patients with a ratio >1 (4 vs. 12 months, p = 0.021) and that of CG (4 vs. 6 months, p = 0.442). CONCLUSIONS: Intrapleural treatment can prolong the survival of NSCLC patients with MPE who do not receive targeted treatment or who only receive chemotherapy. The PE-CEA: B-CEA ratio can be used to predict the efficacy if intrapleural treatment is indicated.

Effect of four viscous soluble dietary fibers on the physicochemical, structural properties, and in vitro digestibility of rice starch: A comparison study.

The effect of carboxymethyl cellulose (CMC), high-methoxyl pectin (HMP), konjac glucomannan (KGM), and xanthan gum (XG) on the physicochemical, structural properties, and digestibility of rice starch were investigated and compared. The four viscous soluble dietary fibers (VSDFs) increased the viscosity, storage modulus and loss modulus while decreased the pasting temperature and gelatinization enthalpy. Moreover, XG produced the lowest peak viscosity and dynamic modulus compared with the other VSDFs. Furthermore, the degree of short-range ordered structure of starch with KGM increased from 0.8448 to 0.8716; and the relative crystallinity of starch with XG increased by 12%. An ordered and reunited network structure was observed in SEM. In addition, VSDF inhibited the digestibility of rice starch and significantly increased the resistant starch content. This study compared the effect of four VSDFs on the physicochemical, structural and digestion properties of rice starch to fully understand and develop their application to starchy foods.