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KMID : 0371620020170010047
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Journal of Wonkwang Medical Science
2002 Volume.17 No. 1 p.47 ~ p.53
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Effectiveness of Pleurodesis with Bleomysin in Management of Malignant Pleural Effusion
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Park Jung-Hyun
Kim Hak-Ryul
Yang Sei-Hoon
Jeong Eun-Taik
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Abstract
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Background : Malignant pleural effusions are common and significant problems in patients with advanced malignancy. Repeated thoracentesis provides temporary symptomatic improvement, but most patients progressively cause dyspnea or pleuritic pain. So pleurodesis with sclerosing agent is effective as a palliative treatment. There are many drugs used as pleural sclerosing agents. But doxycycline hasn’t been used in Korea since 1999. And recently talc has been reported serious side effects. In this study, pleurodesis with bleomycin was prospectively investigated for its short term and middle period effects and its side effects.
Methods : Twenty-six patients with malignant pleural effusion were prospectively analyzed to estimate the effects of bleomycin pleurodesis. Without special management before the procedure, 60 units of bleomycin in 50-100ml of normal saline were instilled into the pleural space via a small bore catheter(8-10 F). Andthen repeated positional changes and rotations were done for 2 hours. We measured the drainage amount and evaluated the side effects after 24 hours and checked the existence of the effusion by chest radiography after 1 month.
Results : After 24 hours, the drainage amount showed that the responder group(none or ≤ 100ml) was 69%, and that the nonresponder group(> 100ml) was 31%. Side effects (high fever in 3 cases and severe pleuritic pain in 1 case) were 15%(4/26), but patients recovered easily by symptomatic management. After 1 month, chest radiography showed that the response rate(complete or partial response) was 73%. Differences of survival times between responder and nonresponder group was not statistically significant.
Conclusions : We are suggest that bleomycin as a pleural sclerosing agent is a relatively simple, safe and effective agent. But a prospective study with a larger number of patients must be warranted.
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KEYWORD
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Malignant pleural effusion, Pleurodesis, Bleomycin
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