Intrapleural chemotherapy for effusion from metastatic breast carcinoma

Abstract

Efficacy of thoracentesis with the instillation of nitrogen mustard or thio-TEPA for malignant pleural effusions due to metastatic mammary carcinoma is investigated. One hundred and thirty-eight patients were evaluated, of whom 93 were treated by aspiration or intercostal tube drainage of the effusion followed by instillation of a cytotoxic agent. The remaining 45 patients received similar intrapleural chemotherapy and subsequent systemic cytotoxic agents several months later. Thirty-eight (27.5%) of the total patients in this study demonstrated an objective response with an average duration of 8.8 months. Subjective improvement was observed in 73 (53%). Rate and duration of response to instillation of nitrogen mustard and thio-TEPA were similar. The use of a recently devised weighted intercostal tube with the same alkylating agents significantly improved the results.