Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: Pre-EDIT: A Randomised, Feasibility Trial of Elastance-Directed Intra-pleural Catheter or Talc Pleurodesis (EDIT) in the Management of Symptomatic Malignant Pleural Effusion Without Obvious Non-expansile Lung
Brief Summary: Malignant Pleural Effusion (MPE) is a collection of fluid inside the chest caused by cancer. It is a common medical problem and often causes severe breathlessness. Patients with this condition generally have a very poor survival and so it is extremely important that they are given effective treatment as soon as possible to minimise the amount of time they have to spend in hospital.

Standard treatment for MPE involves an admission to hospital to drain the fluid and then attempt to prevent the fluid from returning by sticking the lung to the inside of the rib cage with medical talc powder which acts like glue. This is called talc pleurodesis (TP) but unfortunately it fails in about 30% of patients. This is usually because the lung has not fully re-expanded and has not made contact with the inside of the ribs. When this happens, the fluid can be effectively treated with a different type of drainage tube called an indwelling pleural catheter (IPC) which tunnels under the skin and is drained at home by the district nurses.

It is thought that pressure measurements taken from the fluid as it is drained may be able to show doctors whether or not the lung will re-expand before patients are committed to either TP or an IPC. In this research we wish to test if these measurements can be used to choose which is the best first treatment option (TP or IPC) for patients with MPE. We have called this 'EDIT management'. Since it is uncertain whether this new approach will work, patients will be randomised to have either standard treatment or EDIT management. We will compare the two groups to assess whether the patients who had EDIT management had to have fewer repeat procedures over the following 3 months.


Options:
A: Arm Label: 1. Videothoracoscopic talc poudrage (VT); Type: ACTIVE_COMPARATOR; Interventions: Procedure: Videothoracoscopic talc poudrage (VT). | Arm Label: 2. Talc slurry through a chest tube (DT); Type: ACTIVE_COMPARATOR; Interventions: Procedure: Talc slurry through a chest tube (DT). | Intervention Type: PROCEDURE; Name: Videothoracoscopic talc poudrage (VT).; Assigned to Arm(s): 1. Videothoracoscopic talc poudrage (VT) | Intervention Type: PROCEDURE; Name: Talc slurry through a chest tube (DT).; Assigned to Arm(s): 2. Talc slurry through a chest tube (DT)
B: Arm Label: pleurectomy/decortication; Type: EXPERIMENTAL; Interventions: Procedure: pleurectomy/decortication | Arm Label: indwelling pleural catheter; Type: EXPERIMENTAL; Interventions: Procedure: indwelling pleural catheter | Intervention Type: PROCEDURE; Name: pleurectomy/decortication; Assigned to Arm(s): pleurectomy/decortication | Intervention Type: PROCEDURE; Name: indwelling pleural catheter; Assigned to Arm(s): indwelling pleural catheter
C: Arm Label: VATS hyperthermic pleural chemoperfusion; Type: ACTIVE_COMPARATOR; Interventions: Procedure: VATS hyperthermic chemoperfusion | Arm Label: Bedside talc slurry pleurodesis; Type: ACTIVE_COMPARATOR; Interventions: Procedure: Bedside talc slurry pleurodesis | Intervention Type: PROCEDURE; Name: VATS hyperthermic chemoperfusion; Assigned to Arm(s): VATS hyperthermic pleural chemoperfusion | Intervention Type: PROCEDURE; Name: Bedside talc slurry pleurodesis; Assigned to Arm(s): Bedside talc slurry pleurodesis
D: Arm Label: EDIT Management; Type: EXPERIMENTAL; Interventions: Procedure: EDIT Management | Arm Label: Standard Care; Type: ACTIVE_COMPARATOR; Interventions: Procedure: Chest drain and talc pleurodesis | Intervention Type: PROCEDURE; Name: EDIT Management; Assigned to Arm(s): EDIT Management | Intervention Type: PROCEDURE; Name: Chest drain and talc pleurodesis; Assigned to Arm(s): Standard Care

Answer: D