Chest
Clinical Investigations: The PleuraSclerotherapy for Malignant Pleural Effusions: A Prospective Randomized Trial of Bleomycin vs Doxycycline with Small-Bore Catheter Drainage
Section snippets
MATERIALS AND METHODS
Over a 2-year period, all patients with a known malignancy and a symptomatic, cytologically proved or strongly suspected malignant pleural effusion referred to the interventional thoracic radiology service for drainage and sclerotherapy were considered eligible. Patients who had prior sclerotherapy or a drug allergy to one of the sclerosing agents were excluded. No patient had systemic chemotherapy immediately prior to or during the 30-day interval following sclerotherapy. All patients signed
RESULTS
One hundred six patients with a mean age of 59 years were randomized to bleomycin or doxycycline sclerotherapy for the treatment of a malignant pleural effusion.
DISCUSSION
In patients >60 years, most exudative pleural effusions are caused by metastatic disease, most commonly from lung, breast, and ovarian carcinoma, and lymphoma.5, 6, 7 Approximately 50% of patients with breast carcinoma, 25% of patients with lung cancer, and 35% of patients with lymphoma will develop a malignant effusion during the course of their disease.3,8
Malignant pleural effusions are typically exudates, with high protein and lactate dehydrogenase levels. They may also be grossly
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