Bleomycin and tetracycline in malignant pleural effusions: a review

Pleural effusions remain a distressing and symptomatic problem in cancer patients. Once a malignant pleural effusion is diagnosed, appropriate therapy may provide symptomatic relief and improved quality of life. In this paper, we review previous data on chest tube drainage and pleurodesis in patients with malignant pleural effusions. A comparison is made of the various sclerosing agents. Specifically, recent data from a study comparing bleomycin and tetracycline as sclerosing agents are discussed. These data show a clear advantage with bleomycin at both 30-day and 90-day end points--30-day recurrence, 36% versus 67%; 90-day recurrence, 30% versus 53%.