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Evidence summaries

Use of Chemical Pleurodesis for Treatment of Malignant Pleural Effusions

Chemical pleurodesis may be more effective than bleomycin and tetracyclines in the treatment of malignant pleural effusions Level of evidence: "C"

Pleurodesis was performed in 39 patients by thoracoscopic insufflation of talc 1. The outcomes were compared at 30 and 90 days with a control group (n=85) consisting of patients who had participated in a comparative randomized study of the efficacy of similarly administered bleomycin and tetracycline. Among the patients who had received talc, a good outcome was recorded in 97% at 30 days and in 95% at 90 days. The corresponding figures were 64% and 70% in the bleomycin group and 33% and 47% in the tetracycline group.

Comment: The quality of evidence is downgraded by indirectness and imprecise results (few patients).

    References

    • Hartman DL, Gaither JM, Kesler KA, Mylet DM, Brown JW, Mathur PN. Comparison of insufflated talc under thoracoscopic guidance with standard tetracycline and bleomycin pleurodesis for control of malignant pleural effusions. J Thorac Cardiovasc Surg 1993 Apr;105(4):743-7; discussion 747-8. [PubMed]

Primary/Secondary Keywords