Journal Title: پاییز 91
Article title: Determination of the Rate of Recurrence of Pleural Effusion upon Instilling Talc Powder in Patients Suffering from Malignant Pleural Effusion, in Hamadan's Besat Hospital during 2010-2011

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Article abstract:
Introduction & Objective: Pleural malignancies are the third etiology of malignant pleural effusion. About 50% of the patients with metastatic cancers develop this condition. The presence of malignant pleural effusion in such patients often implies a low survival rate and poor therapeutic outcome. This study was aimed to evaluate the frequency of recurrence after Talc powder instill through chest tube into the pleural cavity, among patients with malignant pleural effusion who referred to Besat Hospital in Hamadan, Iran. Materials & Methods: In this prospective observational study, 90 patients with malignant pleural effusion who were admitted to the surgery and hematology-oncology departments of Besat Hospital in Hamadan, during 2010 and 2011 were evaluated. All enrolled patients had confirmed documents of malignant pleural effusion, using radiologic, clinical, and laboratory techniques, including cytological and chemical analysis of pleural fluid. Pleurodesis was performed for all patients by instilling 5 mg of asbestos-free talc powder through a 24F chest tube. After the application of pleurodesis procedure, patients were followed up monthly regarding the treatment response, complications, and recurrence for three months, and the serial radiologic images were compared to the previous ones. The data in the questionnaire and forms were analyzed with SPSS software, version 17, and descriptive statistics Results: In this study a total of 90 patients were involved the mean age of patients was 58.86±12.00 years and 64.4% (n=58) were male. The most common symptom was cough (92.2%), followed by chest pain (81.87%), dyspnea (57.8%), and weight loss (17.8%). The average duration of keeping chest tube was 3.72 days and the average hospital stay was 5.74 days. Lung cancer (n=24, 26.7%) was the most common underlying malignancy. Seventy-nine (87.8%) patients showed successful treatment, while 11 (12.2%) had recurrence. After 3 months of follow-up, cough, chest pain, and dyspnea were reported in 11.1%, 6.7%, and 3.3% of the patients respectively. Fifty-two (57.8%) patients had no significant complications. The most common reported complication was post surgical fever (20%), followed by chest pain (17.8%). Conclusions: The results of this study suggested that Talc powder administration through chest tube is a suitable treatment for the malignant pleural effusion, with low rates of recurrence after 3 months of follow up. However, it is recommended to perform similar investigations, using thoracoscopy to provide comparative information. Also conducting a controlled clinical trial, using other sclerosant materials, is suggested.
Article KeyWords:
Malignant Pleural Effusion, Chest Tube, Talc Powder
Article Authors:

	دکتر محمد رضا جوادی	First Author
	دکتر امیر درخشان‌فر	Other Author	dr_derakhshafar_a@yahoo.com
	دکتر نازیلا فرنوش	Other Author
	دکتر امین نیایش	Other Author
	دکتر سعادت ترابیان	Other Author