Malignant pleural effusions treated with high dose intrapleural doxycycline: clinical efficacy and tolerance

Chronic malignant pleural effusion may be treated by instillating products in the pleural space to induce pleurodesis. We used intrapleural doxycycline at doses greater than 2000 mg in 16 malignant pleural effusion (14 patients). Patient survival ranged from 1 day to 19.5 months. Mean drainage duration was 7.5 days (range, 5-10 days). Pain (moderate n=7; severe n=2) was the most frequent side-effect with hypotension (moderate n=3; severe n=1). Five cases were not evaluable at one month because of death during the month following treatment (n=3) or during treatment (n=2). At one month follow-up, success was defined as no pleural effusion (n=5), partial response as minimal effusion (n=4) and we considered that treatment had failed if pleural drainage was necessary (n=2). Five patients died within one month and 5 had more than 3 months survival (4 without recurrence).