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Sclerotherapy for malignant pleural effusions: a prospective randomized trial of bleomycin vs doxycycline with small-bore catheter drainage.

Publication ,  Journal Article
Patz, EF; McAdams, HP; Erasmus, JJ; Goodman, PC; Culhane, DK; Gilkeson, RC; Herndon, J
Published in: Chest
May 1998

BACKGROUND: Malignant pleural effusions are a common problem for patients with metastatic disease. Most patients are treated with tube thoracostomy and sclerotherapy, although there remains no standard approach. The purpose of this study was to compare the efficacy of bleomycin with doxycycline sclerotherapy for the treatment of malignant pleural effusions using small-bore catheters. METHODS: All patients with a symptomatic malignant pleural effusion referred for chest tube drainage and sclerotherapy over a 2-year period were considered eligible. Using image guidance, a 14F self-retaining catheter was inserted into the pleural space and connected to continuous wall suction. When drainage fell below 200 mL/d, patients were randomized to 60 U of bleomycin or 500 mg of doxycycline sclerotherapy. Response at 30 days was determined. RESULTS: One hundred six patients were enrolled in the study. Fifteen men (29%) and 37 women (71%) with a mean age of 57 years received bleomycin sclerotherapy. Twenty-one of the 29 patients (72%) alive and evaluable at 30 days had successful sclerotherapy. Twenty-three men (43%) and 31 women (57%) with a mean age of 61 years received doxycycline sclerotherapy. Twenty-three of the 29 patients (79%) alive and evaluable at 30 days had successful sclerotherapy. There was no significant difference in response rates between doxycycline and bleomycin (p=0.760). CONCLUSIONS: These data continue to support a role for small-bore chest drainage and sclerotherapy, although there was no significant difference in 30-day response rates between doxycycline and bleomycin.

Duke Scholars

Published In

Chest

DOI

ISSN

0012-3692

Publication Date

May 1998

Volume

113

Issue

5

Start / End Page

1305 / 1311

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Sclerosing Solutions
  • Respiratory System
  • Prospective Studies
  • Pleurodesis
  • Pleural Effusion, Malignant
  • Middle Aged
  • Male
  • Humans
 

Citation

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Patz, E. F., McAdams, H. P., Erasmus, J. J., Goodman, P. C., Culhane, D. K., Gilkeson, R. C., & Herndon, J. (1998). Sclerotherapy for malignant pleural effusions: a prospective randomized trial of bleomycin vs doxycycline with small-bore catheter drainage. Chest, 113(5), 1305–1311. https://doi.org/10.1378/chest.113.5.1305
Patz, E. F., H. P. McAdams, J. J. Erasmus, P. C. Goodman, D. K. Culhane, R. C. Gilkeson, and J. Herndon. “Sclerotherapy for malignant pleural effusions: a prospective randomized trial of bleomycin vs doxycycline with small-bore catheter drainage.Chest 113, no. 5 (May 1998): 1305–11. https://doi.org/10.1378/chest.113.5.1305.
Patz EF, McAdams HP, Erasmus JJ, Goodman PC, Culhane DK, Gilkeson RC, et al. Sclerotherapy for malignant pleural effusions: a prospective randomized trial of bleomycin vs doxycycline with small-bore catheter drainage. Chest. 1998 May;113(5):1305–11.
Patz, E. F., et al. “Sclerotherapy for malignant pleural effusions: a prospective randomized trial of bleomycin vs doxycycline with small-bore catheter drainage.Chest, vol. 113, no. 5, May 1998, pp. 1305–11. Pubmed, doi:10.1378/chest.113.5.1305.
Patz EF, McAdams HP, Erasmus JJ, Goodman PC, Culhane DK, Gilkeson RC, Herndon J. Sclerotherapy for malignant pleural effusions: a prospective randomized trial of bleomycin vs doxycycline with small-bore catheter drainage. Chest. 1998 May;113(5):1305–1311.
Journal cover image

Published In

Chest

DOI

ISSN

0012-3692

Publication Date

May 1998

Volume

113

Issue

5

Start / End Page

1305 / 1311

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Sclerosing Solutions
  • Respiratory System
  • Prospective Studies
  • Pleurodesis
  • Pleural Effusion, Malignant
  • Middle Aged
  • Male
  • Humans