Management of malignant pleural effusion.
Malignant pleural effusion (MPE) often presents in patients with cancer at an advanced stage and thus carries a poor prognosis. This review updates the current knowledge on the management of MPE, focusing on recent literature about the efficacy and safety of the most common methods, including pleurodesis by either thoracoscopy with talc insufflation or thoracostomy with talc slurry, use of an indwelling pleural catheter, and intrapleural chemotherapy. Talc remains the agent of choice in pleurodesis, although the use of alternative agents continues to be explored. The choice of procedure to achieve pleurodesis depends on careful patient selection based on predictive factors and individual characteristics. Talc pleuro-desis is relatively well tolerated and safe, as is an indwelling pleural catheter, in an appropriate patient population. Because MPE is a common problem in cancer patients, future research with more randomized, prospective designs and innovative interventions is needed.
Chen
Hongbin
H
Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, The Bunting/Blaustein Cancer Research Building, 1650 Orleans Street, Baltimore, MD 21231, USA.
Brahmer
Julie
J
D051520:Antiperspirants / Q000627:therapeutic use*; D006801:Humans; D009369:Neoplasms / Q000150:complications*; D010166:Palliative Care; D016066:Pleural Effusion, Malignant / Q000188:drug therapy* / Q000209:etiology; D018700:Pleurodesis; D013627:Talc / Q000627:therapeutic use*
D051520:Antiperspirants; D013627:Talc
J Thorac Oncol. 2007 Aug;2(8):706-14
17762336
Chest. 2006 Feb;129(2):362-368
16478853
Chest. 2005 Sep;128(3):1431-5
16162739
Lancet. 2007 May 5;369(9572):1494-1496
17482965
Chest. 2007 Apr;131(4):1232-4
17426232
J Thorac Oncol. 2007 Aug;2(8):686-93
17762334
J Pain Symptom Manage. 2005 Jul;30(1):75-9
16043010
Chest. 2007 Nov;132(5):1584-90
17890482
Ann Surg Oncol. 2007 Oct;14(10):2700-1
17151792
Eur J Cardiothorac Surg. 2005 Nov;28(5):750-3
16198593
Am J Respir Crit Care Med. 2000 Nov;162(5):1987-2001
11069845
Chest. 2007 Sep;132(3):1036-41
17873197
Ann Surg Oncol. 2007 Oct;14(10):2698-9
17657544
Eur J Cardiothorac Surg. 2006 May;29(5):829-38
16626967
Lung Cancer. 2005 Oct;50(1):123-7
15998551
Chest. 2005 Mar;127(3):909-15
15764775
Eur J Cardiothorac Surg. 2005 Jan;27(1):19-22
15621465
Lancet. 2007 May 5;369(9572):1535-1539
17482984
Clin Cancer Res. 2005 Oct 15;11(20):7444-53
16243818
Ann Oncol. 2006 Dec;17(12):1853
16790519
Lung Cancer. 2006 Oct;54(1):51-5
16920219
Chest. 2006 Feb;129(2):356-361
16478852
Br J Cancer. 2006 Sep 18;95(6):717-21
16940982
Eur Respir J. 2005 Apr;25(4):600-4
15802331
Eur J Cardiothorac Surg. 2008 Jan;33(1):89-94
17983758
Eur J Cardiothorac Surg. 2006 Dec;30(6):827-32
17113008