Alavi Ali Asghar, Eshraghi Mohsen, Rahim Mohammad Bagher, Meysami Ali Pasha, Morteza Afsaneh, Hajian Hanieh
Department of Thoracic Surgery, Tehran University of Medical Sciences, Iran.
Acta Med Iran. 2011;49(9):584-7.
Malignant pleural effusion is a common complication in certain malignancies. Pleurodesis is the best option most of the time. The purpose of this study was to compare the choice of belomycin with povidone-iodine, which is not only determined by the efficacy of the agent but also by its cost, accessibility, safety, ease of administration and the number of administrations to achieve a complete response. We performed a randomized clinical trial on 39 patients presenting with symptomatic malignant pleural effusion. Patients were selected and randomly assigned to undergo chemical pleurodesis with either bleomycin or povidone-iodine. Primary characteristics of patients were assessed and graded before and after treatment concerning pain, dyspnea, and chest radiographs. A complete response was obtained in 79% of belomycin group and 75% of povidone-iodine group which was not statistically significant. Patients on belomycin treatment had a significantly lower score for dyspnea in one month follow up. This was significant after controlling for age, pain score and dyspnea score after drainage, using general linear model. Due to similar effect and significant cost advantage between bleomycin and povidone-iodine, we conclude that povidone- iodine is the agent of choice when utilizing pleurodesis for control of symptomatic malignant pleural effusions.
恶性胸腔积液是某些恶性肿瘤常见的并发症。胸膜固定术在大多数情况下是最佳选择。本研究的目的是比较博来霉素与聚维酮碘的选择，这不仅取决于药物的疗效，还取决于其成本、可及性、安全性、给药便利性以及实现完全缓解所需的给药次数。我们对39例有症状的恶性胸腔积液患者进行了一项随机临床试验。患者被选取并随机分配接受博来霉素或聚维酮碘化学性胸膜固定术。在治疗前后评估并分级患者关于疼痛、呼吸困难和胸部X光片的主要特征。博来霉素组79%和聚维酮碘组75%获得了完全缓解，这在统计学上无显著差异。在随访一个月时，接受博来霉素治疗的患者呼吸困难评分显著更低。使用一般线性模型在控制年龄、疼痛评分和引流后呼吸困难评分后，这一结果具有显著性。由于博来霉素和聚维酮碘效果相似且聚维酮碘具有显著的成本优势，我们得出结论，在利用胸膜固定术控制有症状的恶性胸腔积液时，聚维酮碘是首选药物。
