Intracavitary 5-Fluorouracil in Malignant Effusions

Abstract

ALKYLATING agents have been effective in treatment of effusions into the pleural, pericardial, and peritoneal cavities due to metastatic tumor.^1-4Other forms of treatment are also available at the present time and include radioisotopes, x-ray, talc poudrage, and pleurectomy.^5-9However, there are certain disadvantages associated with the use of each of these agents or procedures. Mechlorethamine hydrochloride (HN₂), one of the nitrogen mustards, frequently causes moderate to severe nausea and vomiting necessitating heavy premedication. Local reactions may occur following intracavitary injection of HN₂resulting in reactive effusions which may require emergency paracentesis. The disadvantages of radioactive isotopes are the lack of ready availability, the expense, and the radiation hazard to the patient and personnel. Furthermore, improvement is obtained with alkylating agents or radioisotopes in only 50% to 65% of the patients. Talc poudrage and pleurectomy may be very effective in controlling recurrent effusions but these techniques require thoracic surgery. Therefore