Bleomycin versus tetracycline pleurodesis for malignant pleural effusions

ABSTRACT

Forty-six patients with symptomatic and/or recurrent cytologically proved malignant pleural effusion were randomized to receive intrapleural instillation of 1 g tetracycline [24 patients] or 60 units bleomycin [22 patients]. Patients were required to have performance status [0-3], lung reexpansion following tube thoracostomy with drainage to <100 ml/24 hours, no prior intrapleural therapy, no prior systemic bleomycin, no recent chest radiation therapy and no change in systemic therapy in the preceding month. Fluid volume before and after pleurodesis, drainage time and side effects were registered and analyzed. Treatment response was evaluated subjectively and objectively by clinical and radiographic examinations. It was concluded that chemical pleurodesis with bleomycin appeared to be more efficient than tetracycline giving a higher and durable response with fewer instillations and shorter stays in hospital which is in favor of a better quality of life and may compensate for its higher cost