PURPOSE: Malignant pleural effusion (MPE) is a common problem in patients with malignancies. The aim of the study was to assess the efficacy of doxycycline with a small-bore (8F) thoracic tube in pleurodesis (P).
METHODS: During 5 years forty-one patients were found to be amenable to P. A small bore (8F) intercostal tube was placed at bed side in all patients. Demographics, clinical manifestations, properties of pleural fluid, complications, effectiveness and survival were analised.
RESULTS: There were 41 patients (26 female, 15 male), mean age 66±13 years. Origin from MPE were: breast 13 (32%), lung 8 (19.5%), ovarian 6 (14.6%), digestive 3 (7%), lymphoma 2 (5%) and others 9 (22%). Effusion was massive in 37%, two-thirds 22%, half 27%, and one-third 15%. Fluid showed a predominance of lymphocytes in 58%. Diagnostic yield of cytology was 74%. A succesful P (complete or partial) was acomplished in 25 (61 %). Mean overall survival was 201±40 days. Patients with a succesful P had a mean overall survival of 266 ±56 in contrast with failed P patients, 78 ±23 days (p=0006). Pain (34%) and fever (2%) were the only reported complications.
CONCLUSION: Doxycycline as chemical pleurodesis through small-bore thoracic tubes has a high success rate with low incidence of complications. Good response to P is associated with an increased survival.
CLINICAL IMPLICATIONS: Pleurodesis with doxycycline is a good option as palliative therapy in patients with symptomatic malignant pleural effusions. The use of small-bore tubes decreases the rate of clinically important complications.
DISCLOSURE: Jaime Signes-Costa, None.