The Outcome of Inserting Intercostal Tube or Pleurodesis for Malignant Pleural Effusion

Condition(s) studied

Investigational drug(s) / intervention(s)

Intercostal chest tube: the use of chest tubes to drain malignant pleural effusion

Pleurodesis: the injection of Talc in pleural space to induce inflammation reaction and produce pleurodesis

Study summary

Approximately half of all patients with metastatic cancer develop a malignant pleural effusion which is likely to lead to a significant reduction in quality of life secondary to symptoms such as dyspnoea and cough. The aim of pleurodesis in these patients is to prevent re-accumulation of the effusion and thereby of symptoms,and avoid the need for repeated hospitalization for thoracocentesis. Numerous clinical studies have been performed to try to determine the optimal pleurodesis strategy, and synthesis of the available evidence should facilitate this. The treatment of MPE is aimed at palliating symptoms since no intervention has been shown to improve survival in this population and since survival is generally limited in cancers that have spread to the pleural space. In this palliative setting, only patients symptomatic from their MPE should be submitted to further intervention. As well, further interventions in symptomatic patients should be limited to those patients who have experienced symptomatic improvement following initial therapeutic thoracentesis. The two main treatment approaches to MPE are to obliterate the pleural space via a pleurodesis procedure or to chronically drain the pleural cavity with Intercostal tube. The aims of this review were to ascertain the optimal procedure in cases of malignant pleural effusion in terms of patients' quality of life post procedure, recurrence of effusion.

Eligibility

Primary outcome measure(s)

• chest imaging, chest x-rays will be used to record the progress of the malignant pleural effusion in both treatments — from the time of intervention up to 6 months
  efficacy of both treatments, in which the treatment that shows less accumulation of pleural effusion in chest imaging gets better results hence is more effective than the other in terms of reducing Malignant Pleural effusion
• A questionnaire will be used to assess tolerability of both treatments on patients — from the time of intervention up to 6 months
  Tolerability, in which the questionnaire will include a score from 1 to 10 in which 1 is the lowest point and 10 is the highest point, it will include how painful each treatment is and how quality of life has changed after each treatment

Trial sites (1)

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