Vincristine (Vinca-Alkaloid) as a sclerosing agent for malignant pleural effusions

Vincristine, extracted from Vinca rosea Linn., is an effective antineoplast ic chemotherapeutic drug used in oncology practice. This drug has never bee n used as a sclerosing agent for the treatment of malignant pleural effusio n for reasons unknown. A study was conducted to examine the use of Vinca-Al kaloid as a sclerosing agent (pleurodesis) for the palliative treatment of malignant pleural effusions. The study included 15 patients, ail diagnosed to have cytology-proven malignant pleural effusions. Intercostal tube drain age followed by chemical sclerotherapy with 2 mg vincristine was performed on all patients and a high success rate was noted. Twelve procedures out of 15 (12/15) achieved complete resolution of pleural fluid with a success ra te of 80%. In two procedures the pleural effusion was reduced and then recu rred but did not require re-aspiration. One procedure failed and repeated p leural aspiration was required. In this study, with adequate pleural draina ge and the proper technique, vincristine was found to be an effective scler osing agent for malignant pleural effusion. Further, randomized trials are necessary in order to establish the role of this drug.