Bleomycin pleurodesis in malignant pleural effusion

Abstract

Objective: This is the first retrospective trial in our country to examine intrapleural bleomycin in terms of effectiveness, safety, and cost. The aim of this study was to investigate the effectiveness, safety and appropriate mode of administration of intrapleural bleomycin for pleurodesis, in the treatment of malignant pleural effusion.

Methods: Between January and July2014, 30 patients presenting to Ibn-alnafees teaching hospital with symptomatic malignant pleural effusions were underwent chemical pleurodesis with bleomycin via bedside thoracostomy. Only the patients with lung re-expansion after drainage entered the study. The conditions of patients were assessed and graded before and after treatment concerning pain, dyspnea, and chest radiographs.

Results: Thirty patients who underwent pleurodesis with bleomycin were available for follow-up. The patients demonstrated notable improvement in both pain and dyspnea following treatment. Permanent control of effusions, defined objectively on chest radiograph, was achieved with bleomycin treatments in 21(70%). The procedures were well tolerated and no significant adverse effects were observed.

Conclusion: This study confirms that intrapleural bleomycin carries good results in the treatment of malignant pleural effusion.  Pleurodesis using bleomycin with 72 hours applied suction should be offered to every patient with malignant pleural effusion, apart from terminally ill ones, provided that a satisfying lung re-expansion has been achieved. A careful selection is essential to define the proper technique.