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Communications to the Editor |

Systemic Distribution of Talc FREE TO VIEW

Carolyn M. Dresler, MD, FCCP (Mount Tabor, NJ)
Author and Funding Information

Correspondence to: Carolyn M. Dresler, MD, FCCP, PO Box 177, Mount Tabor, NJ 07878; e-mail: carolyn.m.dresler@sb.com



Chest. 1999;116(1):266. doi:10.1378/chest.116.1.266
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Published online

To the Editor:

The recent article by Werebe and colleagues (January 1999)1 concerning the systemic distribution of talc was a fascinating and timely study. This group has a very large experience with talc pleurodesis, and they are to be commended in pursuing not only the efficacy of the procedure, but also the safety. As they are aware, a large (n = 500) multicenter trial is underway in the United States exploring the efficacy of talc pleurodesis—administered either through a chest tube as a slurry or via video-assisted thoracoscopy as an insufflated mist—in patients with a malignant pleural effusion. As co-principal investigator of this trial, I have been very sensitive to the potential safety issues relative to talc insufflation. For this reason, I believe we need further studies exploring the results of disseminated talc.

Somewhat surprisingly, all talcs are not equal. The crystal structure and size of the talc particle may vary depending on the location of the talc mine! Perhaps, it is this variability in the size or the structure of the talc that determines the permeability or distribution, and thus potential toxicity of intrapleural talc.

Approximately 250,000 people each year in the United States have a malignant pleural effusion. Talc is the most effective sclerosing agent identified to date. Thus, it is important to confirm its safety. I was very pleased to read this study by Werebe and colleagues and hope that further discussion and research is engendered.

References

Werebe, EC, Pazetti, R, Milanez de Campos, JR, et al (1999) Systemic distribution of talc after intrapleural administration in rats.Chest115,190-193. [PubMed] [CrossRef]
 

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References

Werebe, EC, Pazetti, R, Milanez de Campos, JR, et al (1999) Systemic distribution of talc after intrapleural administration in rats.Chest115,190-193. [PubMed] [CrossRef]
 
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