EFFECTS OF INTRAPLEURAL MITOXANTRONE AND MEPACRINE ON MALIGNANT PLEURAL EFFUSION - A RANDOMIZED STUDY

30 patients with malignant pleuritis were randomised to be treated, ei ther with intrapleural instillation of mepacrine chloride or with mito xantrone. The patients were evaluated with chest X-ray and a symptom q uestionnaire during a follow-up period of 12 weeks. Mitoxantrone level s in the pleural space and plasma were measured at different time poin ts in some of the patients. Nigh concentrations of mitoxantrone were f ound in the pleural fluid while the plasma concentrations were low, gi ving a plasma/intracavity ratio generally of less than 1:60. The chest X-rays showed excellent results for both treatment modalities. Howeve r, the patients treated with mepacrine chloride experienced greater di scomfort with fever and pain, and those treated with mitoxantrone repo rted significantly less dyspnoea and less asthenia after 4 weeks. We c onclude that both treatments are equally effective in preventing the r ecurrence of malignant effusion. However, mitoxantrone seems to have f urther advantages when it comes to improving the quality of life.