Comparison of Vascular Endothelial Growth Factor-A (VEGF-A) Level in Pleural Fluid of Patients with Malignant and Nonmalignant Pleural Effusion

Indonesian female with bilateral chylothorax and mediastinal non-Hodgkin lymphoma: A case report

BACKGROUND

Bilateral chylothorax is leakage and accumulation of lymph fluid in the pleural space on both sides of the lung and in non-traumatic cases, caused mainly by lymphoma.

CASE PRESENTATION

An Indonesian female, 34 years old, complained of short breath, cough, and swelling in several areas (neck, breast, and hands). Chest X-ray and thorax CT scan showed the anterior mediastinal mass and bilateral pleural effusion. Pleural fluid from both hemithorax was yellow and turbid but odorless. Aerobic culture and cytology of pleural fluid were negative. Triglyceride (TG) of both pleural fluids was >110 mg/dL with the ratio of cholesterol/triglyceride of pleural fluid <1 supporting chylothorax. The core biopsy analysis was negative. Non-Hodgkin lymphoma was established by open thoracotomy biopsy and immunochemistry examination. Chylothorax prognosis was an improvement which was reduced after chest tube insertion. On the outpatient, the patient plans chemotherapy with R CHOP regimen (Rituximab + Cyclophosphamide, prednisone, doxorubicin, and vincristine).

DISCUSSION

Malignancy is the primary cause of non-traumatic chylothorax and thoracotomy is used to repair the thoracic duct.

CONCLUSION

Bilateral chylothorax and non-Hodgkin lymphoma were confirmed based on pleural fluid analysis, thoracotomy open biopsy, and immunochemistry examination.

Comparison between Vinorelbine–Carboplatin and Vinorelbine–Cisplatin in Stage III–IV EGFR Mutations-Negative NSCLC

Introduction There are a substantial number of lung cancer patients with negative mutations in Indonesia. This type of cancer is deemed to be the major contributor of lung cancer patient’s death. However, reseaerch related to therapy using vinorelbine combined with platinum-based compounds is still scarce in Indonesia. The aim of this study was to compare the efficacy and tolerability between vinorelbine and carboplatin with vinorelbin and cisplatin in stage III-IV epidermal growth factor receptor (EGFR) mutations-negative non-small cell lung cancer (NSCLC).

Methods The participants were divided into two groups—group I(vinorelbine–carboplatin) and group II (vinorelbine–cisplatin). The participants were assessed based on several measurement criteria. Not only Eq-5D was performed, but the body weight and response evaluation criteria for solid tumors (RECIST) were also examined. The participants received chemotherapy for four cycles (1 cycle = 21 days).

Results The quality of life was considered stable in 60% of group I and 60% of group II (p = 0.255). In both groups, 46.67% of participants had an increased body weight, while the other 20.00% was stable (p = 1.000). In terms of RECIST evaluation after the second cycle, 80.00% of group I and 86.67% of group II were considered to have a stable disease, with 20% of group I and none of group II had partial response (p = 0.027). However, after the fourth cycle, there were no significant difference between the groups (p = 0.734).

Conclusion In EGFR mutation-negative NSCLC patients, the combination of vinorelbine and carboplatin showed comparable outcomes to vinorelbine and cisplatin chemotherapy with no significant differences.