Tratamiento derrames pleurales con quimioterapia, pleural effusions treatment with chemotherapy. Tratamiento de los derrames pleurales malignos con quimioterapia sistémica, después del drenaje con tubo de tórax.

Abstract

Introduction: Pleural effusions are a common complication in cancer. They are usually caused by tumor pleural involvement. The diagnosis is clinical and paraclinical. The therapeutic modalities include chemical pleurodesis, which is not etiological or physiological. Chemotherapy in chemosensitive cancers is a good alternative. The objective of this study was to describe the frecuency of responses to systemic chemotherapy in pleural effusions after drainage. Materials and methods: We included patients with chemosensitive cancers, malignant pleural effusion, no previous chemotherapy, KI >80, life expectancy >6 months. Procedure: Rx thorax, insertion of the tube for evacuating drainage, systemic chemotherapy application, tube removal the day after finishing the chemotherapy. No reproduction of the minimum spill for 6 months. A descriptive statistical analysis was used. Results: 69 patients were studied: Men (37.68%), Women (62.31%). Average age: 59 years. Cancers: bronchogenic carcinoma (43.47%), breast carcinoma (28.98%), ovarian carcinoma (14.49%), carcinoma of unknown origin (7.24%), others (5.79%). Clinical states: IIIb (57.97%), IV (42.02%). Total response: 85.5%. An response was found in cancers of known origin of 90.6% and in cancers of unknown origin of 20%. Recurrence of pleural effusion 14.5%. Conclusions: Systemic chemotherapy after evacuation of the effusion is a good alternative to treat malignant chemosensitive pleural effusions, because it is etiological and has a high response.