Approximately half of all patients with metastatic cancer develop malignant pleural effusions. Because the patients are already terminally ill, these effusions can present significant daignostic and therapeutic challenges. We report our
experience
of
tetracycline pleurodesis for malignant pleural effusions in 28 patients in which 38 procedures were performed, excluded malignant effusion occurred in patients with lung cancer, at Taegu Fatima Hospital from March 1992 to February 1995.
Malignant pleural effusions are commonly associated with breast cancer, stomach cancer, and ovarian cancer. Breast cancer was most common (50.0%). The male to female ratio was 1P3.7. The most common age group was from 46 to 60 years which
accounted
for
57.1% of the patients, and the mean age was 56 years. Major symptoms which were also the indications for attempting pleurodesis were dyspnea, cough, and chest discomfort. Dyspnea was the most common one noted, seen in 76.3% of the patients.
The therapeutic response to pleurodesis was classified into three categories, complete, partial and no response. Complete and partial responses to tetracycline pleurodesis occurred in 65.9% and 18.4% of the procedures, respectively, and so the
overall
response rate was 84.3%. The response rate could not be distinguished by age, sex, type or type of malignancy. major complications of tetracycline pleurodesis were pain and fever which occurred in 31.6% and 13.2% of the procedures, respectively.
This study confirms that tetracycline pleurodesis is a simple and effective measure and can be performed at the bedside in preventing recurrent malignant pleural effusion.
|