EDITORIALS
Pleurodesis for malignant pleural effusion: talc, toxicity and where next?
1 Oxford Pleural Disease Unit, Oxford Centre for Respiratory Medicine and University of Oxford, Oxford, UK
2 Centre for Respiratory Research, University College London, London, UK
Correspondence to:
Dr Robert J O Davies, Oxford Centre for Respiratory Medicine, Churchill Hospital, Oxford OX3 7LJ, UK; robert.davies@ndm.ox.ac.uk
| The first 150 words of the full text of this article appear below. |
Malignant pleural effusion accounts for 22% of all pleural effusions, and affects about 300 000 patients annually (UK and USA). Approximately 50% of patients with breast cancer, 25% of those with lung cancer and >90% with pleural mesothelioma develop a symptomatic malignant pleural effusion. Thoracentesis provides effective short term symptomatic relief but most large malignant pleural effusions recur,1 and pleurodesis is then the standard treatment. A wide range of compounds have been used as pleurodesing agents, but talc is preferred by the majority of respiratory physicians worldwide.2
The Medicines and Healthcare Products Regulatory Authority (MHRA) has recently completed an urgent review of the safety of talc as a pleurodesis agent for malignant effusion, reclassifying it as a medicinal product rather than medical device.3 This review requires that from January 2008, manufacturers must submit regulatory data if they wish their talc preparation to be used for pleurodesis. This is a milestone
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This article has been cited by other articles:
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Davies, H E, Lee, Y C G, Davies, R J O
(2009). Authors' reply. Thorax
64: 274-274
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Tschopp, J M, Schnyder, J M, Astoul, P, Noppen, M, Froudarakis, M, Bolliger, C T, Gasparini, S, Tassi, G F, Rodriguez-Panadero, F, Loddenkemper, R, Aelony, Y, Janssen, J P
(2009). Pleurodesis by talc poudrage under simple medical thoracoscopy: an international opinion. Thorax
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