Pleurodesis with iodized talc for malignant effusions using pigtail catheters.

OBJECTIVE

To assess the efficacy of using an iodized talc slurry as a sclerosing agent instilled into the pleural space via a 12-French pigtail catheter for controlling malignant pleural effusions.

DESIGN

A prospective study in which patients were followed until their death.

SETTING

A university-affiliated tertiary-care teaching hospital.

PATIENTS

Medical oncology patients admitted with symptomatic malignant pleural effusions were considered for iodized talc pleurodesis.

MAIN OUTCOME MEASURES

The control of pleural effusion. Treatment failure was defined as any reaccumulation of fluid in the pleural space.

RESULTS

Fifteen patients were treated for a total of 17 instillations. The median follow-up on all patients until death was 6 months (range 1-20). The most frequent adverse effect in the study group was pleuritic chest pain (60%). The probability of control of effusion, as determined by the method of Kaplan-Meier, was 81% (SEM 9.7%). The cost of preparing 5 g of iodized talc was $4.32 (US).

CONCLUSIONS

Iodized talc slurry instilled through a small-bore pigtail catheter is a safe, economical, and effective treatment for malignant pleural effusion.