Intrapleural bleomycin in malignant pleural effusion

ABSTRACT

This study included twenty patients with malignant pleural effusion, proved with fluid cytology and/or pleural biopsy. The primary tumour was lung cancer in 8 cases, lymphoma in 2 cases, breast in 6 cases, ovary in one case and the primary site was undefined in 3 cases. A tube drainage over 24 hours was performed followed by introduction into the pleural cavity of 100 ml saline containing 90 mg bleomycin and the tube was clamped for 24 hours before drainage of the residual fluid. The response rate was achieved by serial follow-up X ray chest and ultrasound examination to detect the amount of pleural effusion. It was defined as no recurrence of effusion or asymptomatic recurrence of effusion not requiring aspiration for greater than 30 days. The overall response rate was 70 percent. The side effects were pain in8 cases [40 percent], fever in 6 cases [30 percent] and gastrointestinal symptoms in 4 cases [20 percent]. It is concluded that tube drainages with local application of bleomycin is an effective and safe method in the control of rapid recurrent malignant pleural effusion