Comparison between pleurodesis results by 50 glucose solution, versus Bleomycin pleurodesis in patients with malignant pleural effusion

Abstract

BACKGROUND: Following parapneumonic effusions, malignant pleural effusions (MPEs) stand as the second most common cause of exudative pleural effusions. These effusions typically remain unresponsive to systemic chemotherapy, necessitating novel therapeutic approaches. This study aims to ascertain the effectiveness of intrapleural injection with a 50 glucose solution and to compare it with intrapleural injection of Bleomycin sulfate in treating malignant pleural effusion. METHODS: This prospective, double-blind, randomized clinical trial was conducted at Al-Zahra Hospital in Isfahan. The study protocol gained approval from the Iranian Registry of Clinical Trials (IRCT code: IRCT20201013049017N1) (https://en.irct.ir/trial/52739). The study population encompassed patients with malignant pleural effusion. Sampling occurred through a census approach from October 2019 to March 2020. The first group received a pleurodesis solution containing 12.5 cc of 2 lidocaine with Bleomycin, while the second group received a solution comprising 200 cc of 50 glucose solution (10 grams of glucose) and 12.5 ml of 2 lidocaine, within the same volume. These solutions were injected into the pleural space via the chest tube. RESULTS: The complete response rate to treatment three months post-injection was 71.9 in the Bleomycin sulfate group and 65.6 in the 50 dextrose group. However, the difference between the two groups did not achieve statistical significance (P = 0.689). The incidence of post-injection fever and pain intensity exhibited comparability in both groups. CONCLUSION: The treatment involving a combination of 50 glucose solution with Bleomycin for pleurodesis in patients with malignant pleural effusion demonstrated outcomes akin to other treatment options.