Pleurodesis as a palliative treatment of advanced lung cancer with malignant pleural effusion.

PURPOSE This study was conducted to evaluate the success rate of management of advanced. Lung cancer patients with malignant pleural effusion comparing talc powder with tetracycline for pleurodesis. PATIENTS AND METHODS We report 60 patients with lung cancer associated with malignant pleural effusion treated in the department of surgery NCI, Cairo University, between January. 1998 and February, 2003. Patients were Divided Into Three Groups: Group I: Pleurodesis using tetracycline (20 patients). Group II: Pleurodesis using talc slurry (20 patients). Group III: Pleurodesis using talc insufflation (20 patients). Good response to pleurodesis is defined as no pleural fluid re-accumulation or minimal pleural fluid re-accumulation not causing symptoms or requiring further aspiration for one month. RESULTS There were 34 males and 26 females, mean age was 54 years with range of 42-66 years, right sided effusion was present in 32 patients (53%) and left sided in 28 patients (47%). Pathological subtypes were adenocarcinoma in 32 patients, squamous cell carcinoma in 18 and undifferentiated carcinoma in 10 patients. In group I, 12 patients (60%) showed good response to intrapleural tetracycline, 15 patients (75%) responded in group II, while 17 patients (85%) showed good response in group III. Post pleurodesis complications included, fever, chest pain and empyema. CONCLUSION It is concluded from this study that thoracoscopic talc insufflation was an effective, easy and low cost method for producing pleurodesis in patients with recurrent malignant pleural effusion and proved to be better than talc slurry and tetracycline.