Long-term effect and tolerance of talc slurry for control of malignant pleural effusions

Drainage of malignant pleural effusions (MPE) by thoracocenthesis and subse quent pleurodesis is an established means of symptomatic relief in terminal ly-ill patients, but the optimal therapy remains unclear. Among many sclero sing agent, talc is the most widely used, but its intrapleural administrati on and dosage have not been clearly determined. To assess the efficacy of u sing talc slurry with high dose (8 g) as a sclerosing agent instilled into the pleural space at the patient bedside, we carried out a study in 31 pati ents suffering from symptomatic MPE, followed until death or up to 1 year w ith radiographs. Patients were evaluated for immediate tolerance (31 patien ts), and for efficacy and longterm tolerance (27 patients) of the talc ther apy. We have shown, that pleurodesis was satisfactory in 22/27 patients (81 .4%). This result appeared comparable with other series. Moreover, we obser ved a long-lasting efficacy: within 6 months and within 12 months after tal c instillations, 20/20 patients and 9/9 patients respectively were symphyse d with efficacy. Complications related to talc (8 g) were rare and moderate (pain, fever). Taking into account some technical aspects of talc instilla tion for good performance of the therapy, we recommend this method as the o ptimal route of administration.