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Palliative treatment of malignant pleural effusions: value of small-bore catheter thoracostomy and doxycycline sclerotherapy.

Publication ,  Journal Article
Seaton, KG; Patz, EF; Goodman, PC
Published in: AJR Am J Roentgenol
March 1995

OBJECTIVE: This study evaluates small-bore catheter thoracostomy combined with doxycycline sclerotherapy for palliative treatment of presumed malignant pleural effusions. SUBJECTS AND METHODS: Forty-seven consecutive patients referred from the medical oncology department to the thoracic radiology section with known primary malignant tumors and symptomatic pleural effusions over a 2-year period were treated with small-bore pleural catheter drainage followed by doxycycline sclerotherapy. Of the 47 patients, 20 (43%) died less than 30 days after sclerotherapy, one (2%) died without radiographic follow-up, and five (11%) were lost to follow-up. Twenty-one patients formed the study group. Response to treatment was defined based on findings on follow-up chest radiographs obtained 30 days after sclerotherapy as complete (no reaccumulation of pleural effusion), partial (accumulation above postpleurodesis level but below that at presentation), or as a failure (reaccumulation to the amount seen at presentation). RESULTS: Seventeen (81%) evaluable patients showed complete response to sclerotherapy, three (14%) showed a partial response, and one (5%) showed no response. All complete and partial responders were clinically improved with resolution of their shortness of breath. Therefore, 95% of evaluable patients had clinically and radiographically successful treatment. Six patients underwent sclerotherapy when their tube output was greater than 100 ml/24 hr. Five of the six had completely successful pleurodesis, and one failed to respond. Two (10%) of the 21 patients had greater than 150 ml drainage in the 24 hr after initial doxycycline administration and were therefore given a second dose of intrapleural doxycycline. Both of these patients subsequently had less than 150 ml drainage in an additional 24-hr observation period and went on to complete response. Complications included three patients (14%) with mild discomfort at the chest tube site during drainage, one patient (5%) with pain during instillation of doxycycline, and one patient (5%) with transient fever (38.3 degrees C body temperature) one day after sclerotherapy. CONCLUSION: Small-bore catheter thoracostomy followed by doxycycline sclerotherapy successfully resolves symptomatic pleural effusion in patients with known primary malignant tumors.

Duke Scholars

Published In

AJR Am J Roentgenol

DOI

ISSN

0361-803X

Publication Date

March 1995

Volume

164

Issue

3

Start / End Page

589 / 591

Location

United States

Related Subject Headings

  • Thoracostomy
  • Sclerotherapy
  • Pleural Effusion, Malignant
  • Palliative Care
  • Nuclear Medicine & Medical Imaging
  • Middle Aged
  • Male
  • Humans
  • Female
  • Drainage
 

Citation

APA
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ICMJE
MLA
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Seaton, K. G., Patz, E. F., & Goodman, P. C. (1995). Palliative treatment of malignant pleural effusions: value of small-bore catheter thoracostomy and doxycycline sclerotherapy. AJR Am J Roentgenol, 164(3), 589–591. https://doi.org/10.2214/ajr.164.3.7532350
Seaton, K. G., E. F. Patz, and P. C. Goodman. “Palliative treatment of malignant pleural effusions: value of small-bore catheter thoracostomy and doxycycline sclerotherapy.AJR Am J Roentgenol 164, no. 3 (March 1995): 589–91. https://doi.org/10.2214/ajr.164.3.7532350.
Seaton, K. G., et al. “Palliative treatment of malignant pleural effusions: value of small-bore catheter thoracostomy and doxycycline sclerotherapy.AJR Am J Roentgenol, vol. 164, no. 3, Mar. 1995, pp. 589–91. Pubmed, doi:10.2214/ajr.164.3.7532350.

Published In

AJR Am J Roentgenol

DOI

ISSN

0361-803X

Publication Date

March 1995

Volume

164

Issue

3

Start / End Page

589 / 591

Location

United States

Related Subject Headings

  • Thoracostomy
  • Sclerotherapy
  • Pleural Effusion, Malignant
  • Palliative Care
  • Nuclear Medicine & Medical Imaging
  • Middle Aged
  • Male
  • Humans
  • Female
  • Drainage