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Management of malignant pleural effusions
F Grossi1, M C Pennucci, L Tixi
1Division of Medical Oncology I, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy.
Drugs
|February 17, 1998
Summary
Malignant pleural effusions (MPEs) are common in advanced cancer. Appropriate therapy, often pleurodesis with agents like talc or bleomycin, can effectively manage symptoms and improve patient outcomes.
Area of Science:
- Oncology
- Pulmonology
- Palliative Care
Background:
- Malignant pleural effusions (MPEs) are a frequent and symptomatic complication of advanced cancers.
- Effective palliation is achievable for most patients with appropriate therapeutic strategies.
Purpose of the Study:
- To review and describe various treatment options for managing MPEs.
- To provide guidelines for allocating patients to the most suitable MPE treatments.
Main Methods:
- Literature review of reported treatments for MPE management.
- Analysis of therapeutic options including systemic therapy, thoracocentesis, and pleurodesis.
- Discussion of sclerosing agents for pleurodesis, focusing on talc and bleomycin.
Main Results:
- Systemic therapy can control effusions in sensitive malignancies.
- Thoracocentesis is suitable for limited life expectancy or slow recurrence.
- Pleurodesis via tube thoracostomy is the primary treatment for most remaining cases.
Conclusions:
- Talc and bleomycin are considered cost-effective agents for pleurodesis.
- Optimal agent selection for pleurodesis remains debated due to study heterogeneity.
- Guidelines are needed to standardize MPE treatment allocation for better patient care.