[Tetracycline pleurodesis for treatment of malignant pleural effusions. Retrospective study of 91 cases].
BACKGROUND
Malignant pleural effusions (MPE) are a common complication in patients with advanced neoplasms. Even though no large series confirming this exist, tetracycline pleurodesis has become the therapy of choice. The aim of this retrospective study was to evaluate its efficacy, adverse effects and possible factors predicting the success of the method.


METHODS
Between 1985 through 1991, 91 patients with cytologically or histologically confirmed MPE were treated with 1,000-1,500 mg tetracycline pleurodesis. There were 49 females and 42 males, with a mean age of 59 years. The most common malignancies were lung, breast and unknown primary carcinomas. 85% patients complained of dyspnea and the volume of the effusion was moderate in half the cases. 12 variables were analyzed in relation with the probability of response through chi 2 test; survival and recurrence times were calculated with Kaplan and Meier's method.


RESULTS
73 patients were evaluable, with a 67% response rate (22 complete, 27 partial). Time to relapse was significantly higher for partial responses (mean 112 days) than for failures (mean 33 days). 37 patients presented mild complications (pain and fever). Karnofsky performance status (70% or greater), size of the effusion (small or moderate), chest radiograph (only effusion) and pleural LDH (600 U/l or less) attained favourable prognostic significance. Median survival was reached at 6 months.


CONCLUSIONS
Tetracycline pleurodesis is an effective and well-tolerated paliative treatment for MPE. Along with other known parameters (pleural pH and glucose levels), Karnofsky performance status, size of the effusion, chest radiograph and pleural LDH allow to predict its results and optimize its indications.
Martínez Moragón
E
E
Servicio de Neumología, Hospital Universitario La Fe, Valencia.
Aparicio Urtasun
J
J
Sanchis Aldás
J
J
Fullana Monllor
J
J
Sanchis Moret
F
F
Montalar Salcedo
J
J
Marco Martínez
V
V
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004322:Drainage; D005260:Female; D006801:Humans; D007322:Instillation, Drug; D008297:Male; D008875:Middle Aged; D016066:Pleural Effusion, Malignant / Q000628:therapy*; D012074:Remission Induction; D012189:Retrospective Studies; D016019:Survival Analysis; D013752:Tetracycline / Q000008:administration & dosage* / Q000627:therapeutic use
D013752:Tetracycline
Pleurodesis con tetraciclinas en el tratamiento del derrame pleural maligno. Estudio retrospectivo de 91 casos.