Ba. Goff et al., SMALL CHEST-TUBE DRAINAGE FOLLOWED BY BLEOMYCIN SCLEROSIS FOR MALIGNANT PLEURAL EFFUSIONS, Obstetrics and gynecology, 81(6), 1993, pp. 993-996
Objective: To review our experience with bleomycin sclerotherapy as tr
eatment of pleural effusions due to gynecologic malignancies. Methods:
Twenty-one women with histologically documented malignant effusions (
16 ovarian carcinoma, three uterine sarcoma, and two cervical cancer)
were treated with small flexible chest-tube drainage followed by intra
pleural bleomycin sclerotherapy (60 units). Results: After placement o
f the chest tube, suction was required for a median of 5 days (range 3
-12) before output was low enough (less than 100 mL/24 hours) to insti
ll bleomycin. Among 24 treated effusions, there was a 71% overall resp
onse rate, including ten complete responses (42%) and seven partial re
sponses (29%); seven effusions (29%) did not respond to therapy. Six o
f the seven patients whose effusions did not respond to bleomycin died
of disease within 2 months of attempted sclerotherapy. Fever was the
most common side effect, occurring in 13 of 21 patients (62%) followin
g instillation of bleomycin. Pain during sclerosis was reported by onl
y two patients. Conclusion: Bleomycin sclerotherapy after small flexib
le chest-tube drainage of malignant pleural effusions is an effective
technique, with minimal adverse reactions, for controlling effusions t
hat develop in women with gynecologic malignancies.