Management of peritoneal effusions with intracavitary mitoxantrone or bleomycin

Peritoneal effusion is a common complication in disseminated cancer. Intracavitary instillation of various agents has achieved control rates of 30-60% with no rational preference for one agent or another. However, serious side effects have also been observed and deaths due, for instance, to bleomycin have been reported. Mitoxantrone has recently been tested to treat effusions, and preliminary results suggest the high efficacy of this drug in the treatment of peritoneal, pericardial and pleural effusions. Nevertheless, some results have been conflicting. In the present study, 41 patients with peritoneal effusions were treated with intracavitary bleomycin or intracavitary mitoxantrone. The median duration of control of effusion was 5 months (range 1 week to 14 months) with mitoxantrone and 4 months (range 1 week to 12 months) with bleomycin. We conclude that, taking into account their limitations, both agents can be used successfully in the treatment of peritoneal effusions.