A phase II trial of triamcinolone hexacetanide for symptomatic recurrent malignant ascites

Citation
Jr. Mackey et al., A phase II trial of triamcinolone hexacetanide for symptomatic recurrent malignant ascites, J PAIN SYMP, 19(3), 2000, pp. 193-199
Citations number
23
Language
INGLESE
art.tipo
Article
Categorie Soggetti
General & Internal Medicine","Neurosciences & Behavoir
Journal title
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT
ISSN journal
0885-3924 → ACNP
Volume
19
Issue
3
Year of publication
2000
Pages
193 - 199
Database
ISI
SICI code
0885-3924(200003)19:3<193:APITOT>2.0.ZU;2-2
Abstract
Ascites is a common complication of advanced cancer and frequently requires paracentesis to reduce symptoms of pain, anorexia, and dyspnea. For many p atients repeat paracenteses are required at short intervals. We prospective ly studied 15 patients with recurrent ascites of malignancy to determine if intraperitoneal triamcinolone hexacetonide, a slowly metabolized corticost eroid, produced objective and symptomatic responses. After biochemical, rad iological, and symptom assessment and the establishment of the interval bet ween paracenteses, patients underwent large-volume paracentesis followed by intraperitoneal triamcinolone hexacetonide 10 mg/kg. Patients were followe d after treatment for assessment of symptoms and physical signs of ascites. Repeat paracentesis was performed when symptomatic ascites recurred. Sympt omatic ascites recurred in 13 of 15 patients, but the interval between para centeses was extended from 9.5 +/- 1.6 days to 17.5 days (P = 0.0086). Symp tom questionnaire scores assessing well-being, nausea, abdominal pain, dysp nea, appetite, appearance, and change in abdominal size on a scale from 0 t o 6 averaged 3.2 +/- 0.3 at entry and 2.5 +/- 0.2 at the 2-week assessment (P = 0.026). Self-assessed symptoms, feeling of well-being, abdominal diste ntion,and physical appearance improved significantly. The mean serum cortis ol decreased from baseline, suggesting median survival of 42 days. Potentia l adverse effects include 1 episode each of transient abdominal pain, bacte rial peritonitis, and localized hepes zoster infection. In patients with as cites of malignancy, intraperitoneal triamcinolone hexacetonide appears to postpone the requirement for repeat paracentesis and improve symptoms of ma lignant ascites. (C) U.S. Cancer Pain Relief Committee, 2000.