The Therapeutic Interventions in Malignant Pleural Effusions Trial (the TIME trial)

这次申请是为了我进行临床试验，以提高对肺胸壁间异常胸腔积液患者的护理，并为我提供临床试验方面的培训。在英国和美国，每年有超过25万名患者在肺和胸壁之间出现积液，导致呼吸困难。这种液体最常见的原因之一是肺和胸壁之间膜上的癌细胞改变了液体调节。为了控制这种液体，将一种刺激性药物应用于胸腔，在那里液体聚集引起炎症，使肺粘附在胸壁上。这种治疗非常痛苦，这种痛苦可以通过使用非甾体类止痛药而不是阿片类止痛药（标准治疗）和使用小胸管输送药物来减轻。然而，从理论上讲，这种非甾体镇痛药可能会损害这种治疗的效率。该试验将确定非甾体镇痛药和小口径胸管是否能减轻疼痛，以及非甾体镇痛药是否真的能改变治疗效果。无论结果如何，这项研究将为治疗这些患者提供新的信息，并为我提供临床试验方法的全面培训。

This application is for me to perform a clinical trial to improve care for patients with abnormal chest fluid collections between the lung and the chest wall, and to provide me with training in clinical trials. Over 250,000 patients in the UK and US each year develop fluid collections between the lung and the chest wall, which causes disabling breathlessness. One of the commonest causes of such fluid is cancer cells in the membranes between the lung and the chest wall that alter fluid regulation. To control this fluid, an irritant drug is applied to the chest cavity where the fluid collects to cause inflammation, adhering the lung to the chest wall. This treatment is very painful and this pain may be reduced by using non-steroidal painkillers rather than opiate painkillers (standard care), and by using small chest tubes for drug delivery. However, such non-steroidal analgesics may, theoretically, impair the efficiency of this treatment. This trial will establish if non-steroidal analgesics and small bore chest tubes can decrease pain, and whether non-steroidal analgesics do actually change treatment effectiveness. Whatever its result, this study will produce new information about treating these patients and will provide me with a thorough training in clinical trial method.