Pleural effusions

Pleural effusions are a common development in patients with cancer. The optimal means of control are not defined, but systemic treatment is often effective in patients with drug-sensitive tumors. Local treatments advocated in the management of malignant pleural effusions differ in the means of drainage, the length of time pleural tubes are left in situ, and the type of intrapleural therapy administered. Randomized trials published in the past few months have suggested that bleomycin sulfate may be superior to tetracycline as a sclerosant and that mitoxantrone does not add to control of effusions compared with large-bore pleural tube alone placed at time of thoracoscopy.