Summary of prospective studies on pleurodesis, 2003–2007
| First author [ref.] | Year | Sclerosant | Pleurodesis | Predictors of success | ||
| Inclusion (in)/exclusion (ex) criteria | Success % (n) | |||||
| At 3 months | Intention-to-treat analysis | |||||
| Psathakis 20 | 2006 | Talc poudrage | Ex: alive <1 month, proven benign. | 92 (168) | Nominator unknown | Increase in neutrophils in pleural fluid |
| Goodman 15 | 2006 | Talc slurry, early versus late drain removal | In: confirmed MPE; ex: expected survival <3 months, KPS ≤40%, evidence of trapped lung following drainage, earlier pleurodesis | 87 (16) 24-h group; 78 (19) 72-h group | 73 (19) 24-h group; 68 (22) 72-h group | None given |
| Stefani 21 | 2006 | Talc poudrage versus slurry | In: lung expansion after drainage, acceptable performance status, life expectancy >3 months | 63 (109) overall result | 56 (122) | Breast cancer patients (compared to other malignancies) |
| Kolschmann 22 | 2005 | Talc poudrage | In: 180-day FU completed, fit for thoracoscopy; ex: poor-performance patients | 82 (46) | 37 (102) | None given |
| Dresler 17 | 2005 | Talc poudrage versus slurry | In: life expectancy >2 months, ECOG ≤2; ex: previous pleurodesis | 71 (130) slurry; 78 (152) poudrage: >90% lung expansion and alive | 53 (240) slurry; 60 (242) poudrage as reported in paper | None given |
| Paschoalini 23 | 2005 | Talc slurry versus silver nitrate | In: cytologically proven, KPS >60%, life expectancy >1 month; ex: trapped lung | 100 (16) slurry; 89 (9) silver nitrate | 40 (60) for whole population | None given |
| Haddad 24 | 2004 | Talc versus bleomycin | In: recurrent MPE, thoracentesis with clinical relief and lung expansion; ex: KPS <30%, earlier pleurodesis, infection or chronic air leak | 85 (?) talc slurry; 80 (?) bleomycin (success rate calculated on survivors; median survival 2.5 months) | ?% (37) talc slurry; ?% (33) bleomycin | >900 mL evacuated on first thoracentesis |
| Ukale 25 | 2004 | Talc slurry versus quinacrine | In: “eligible for thoracoscopy and pleurodesis” | Early success defined as drop in fluid production during drainage to <50 mL·24 h−1 | Success percentage cannot be calculated from data presented | Complete expansion of the lung, “failures had lower glucose levels” and pH no predictor |
| Sartori 18 | 2004 | Bleomycin versus recombinant IFN-α | In: cytologically proven MPE, ≥2 thoracenteses and >3 L drained in 4 weeks, radiologically proven lung expansion, KPS>40% | 84 (83) bleomycin; 62 (77) IFN-α | None given | |
| Maskell 26 | 2004 | Graded versus mixed talc | In: cytologically proven; ex: expected survival <6 weeks, trapped lung after drainage | 79 (11/14) mixed talc survivors; 85 (12/14) graded-talc survivors | 41 (56) | None given |
| Crnjac 19 | 2004 | Pleural abrasion versus talc slurry | In: breast cancer, therapy-resistant, morphologically confirmed MPE, fit for surgery | 13 (45) mechanical pleurodesis; 26 (42) talc slurry | pH >7.3 | |
| Kuzdzal 27 | 2003 | Talc powder versus doxycycline | Ex: mesothelioma, no full re-expansion of the lung, no histological confirmation of malignant pleurisy | 100 (18) talc; 40 (15) doxycycline | 44 (54) whole population | None given |
Studies were identified by PubMed search using the terms “pleurodesis” and “pleural effusion, malignant”. The search was limited to full papers in the English language. IFN: interferon; MPE: malignant pleural effusion; KPS: Karnofsky Performance Status; FU: follow-up; ECOG: Eastern Cooperative Oncology Group [status]; ?: data not given in study.