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Compared a permanent drain you empty at home with the older operation that glues the lung to the chest wall, and found both relieve breathlessness equally, so the choice is about what a patient wants.
A malignant pleural effusion is one of the commonest causes of disabling breathlessness in lung cancer, and it recurs. TIME2 recruited 106 of 143 patients at seven United Kingdom hospitals between April 2007 and February 2011 and randomised them to an indwelling pleural catheter, inserted as an outpatient with a large initial drainage, education and subsequent home drainage, or to admission for chest tube insertion and talc slurry pleurodesis. Patients scored their breathlessness daily on a 100 mm visual analogue scale for 42 days; 10 mm is the minimum clinically important difference.
Breathlessness improved in both groups and there was no significant difference over the first 42 days: mean score 24.7 mm (95 percent confidence interval 19.3 to 30.1) with the catheter against 24.4 mm (19.4 to 29.4) with talc, a difference of 0.16 mm (-6.82 to 7.15, p=0.96). The catheter group spent fewer days in hospital; the talc group needed fewer further pleural procedures.
TIME2 is why an indwelling pleural catheter is offered as a first-line option rather than a salvage one, and why the decision is framed around hospital time and trapped lung rather than around symptom control, which the two methods deliver equally.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
106 randomised.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Mean breathlessness, 0-42 days (100 mm visual analogue scale)primary | Indwelling pleural catheter | - | 24.7 | - | 0.96 | link |
| Chest tube and talc pleurodesis | - | 24.4 |
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