Intracavitary bleomycin for the control of malignant effusions

Bitran, Jacob D.; Brown, Charles L.; Desser, Richard K.; Kozloff, Mark; Shapiro, Cheri J.; Billings, Arthur A.

doi:10.1002/jso.2930160312

Cited by 61 publications

(19 citation statements)

References 14 publications

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“…Bleomycin seems to cause less pain during instillation, but is more expensive than tetracycline. Data on effectiveness are not conclusive [8,14,15].…”

Section: Discussionmentioning

confidence: 99%

Pleurodesis in malignant pleural effusions: a randomized study of tetracycline versus bleomycin

Martínez‐Moragón

Aparicio²,

Rogado³

et al. 1997

Eur Respir J

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Malignant pleural effusions are commonly managed with tube thoracostomy drainage followed by chemical pleurodesis. Both tetracycline and bleomycin have been shown to be effective for intrapleural instillation, although neither agent has definitively proved advantages over the other. The aim of the present study was to compare these two agents in terms of response rate and toxicity profile.A prospective, randomized trial was carried out in a single centre. Between May 1993 and January 1996, 62 evaluable patients with proved malignant pleural effusion were allocated to receive either intrapleural tetracycline (1.5 g) or bleomycin (60 mg) after the same drainage procedure. Demographic, clinical and fluid parameter data were comparable in both groups. Response was evaluated at 1, 3 and 6 months after pleurodesis.Mean survival and time to relapse did not differ between the two groups. No statistically significant differences were found in terms of efficacy at each evaluation time. Overall, 16 (52%) and 20 (64%) patients had a recurrence of pleural effusion during follow-up in the tetracycline and bleomycin arms, respectively. Fever was most common in bleomycin-treated patients (p=0.024) while pain was most frequent in the tetracycline arm (nonsignificant).Since no study agent was superior to the other in this trial, we suggest that economic costs, drug availability and medical skill should be considered in the choice of a sclerosing agent.

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“…Bleomycin seems to cause less pain during instillation, but is more expensive than tetracycline. Data on effectiveness are not conclusive [8,14,15].…”

Section: Discussionmentioning

confidence: 99%

Pleurodesis in malignant pleural effusions: a randomized study of tetracycline versus bleomycin

Martínez‐Moragón

Aparicio²,

Rogado³

et al. 1997

Eur Respir J

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“…Bleomycin is an antitumor antibiotic which is 85% effective in controlling malignant pleural effusion [1,[100][101][102][103][104][105][106][107]. The dose generally employed is 60U in 50ml of DsW injected through the chest tube.…”

Section: Chest Tube Drainagementioning

confidence: 99%

Diagnosis and treatment of malignant pleural effusion

1987

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Pleural effusion is a common and important complication of malignancy which may at times be difficult to diagnose or treat. Its well recognized association with numerous diseases plus the limitations of our usual diagnostic tests may occasionally cause difficulty. In the oncology patient there are a number of common medical problems associated with the development of pleural effusion which frequently coexist with the malignancy. Pleural effusion may be a presenting or late sign of cancer, and when recurrent can be a vexing symptomatic problem. Fortunately, an increasing number of effective diagnostic and therapeutic modalities are available which, when judiciously applied, facilitate our approach.

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“…4 Some antibiotics have demonstrated a sclerosing effect (tetracycline), 5 whereas no marked efficacy has been observed for others (macrolides and quinolones). 6 Similarly, antineoplastic agents (bleomycin), 7 immunostimulants (Corynebacterium parvum and OK-432), 8,9 chemical irritants (talc and silver nitrate), 10,11 and more recently, biological mediators of inflammation (transforming growth factor-beta (TGF-β) and interferon) 12,13 have been effective in the production of pleurodesis. The use of povidone-iodine, 14 autologous blood, 15 and polidocanol 16 has also been reported in some studies.…”

mentioning

confidence: 99%