Comparison of the efficacy Talc solution injection through Chest Tube and Talcum Powder through Pleuroscopy for the Treatment of Malignant Pleural Effusion: a randomized clinical trial

Background: The aim of the present study was to compare the different outcomes and response rates of talc powder injection via chest tube and talc spray through thoracoscopy in the treatment of malignant pleural effusion in patients. Methods: In this randomized controlled trial, patients with malignant pleural effusion, who were hospitalized in the surgery and hematology-oncology departments of Shariati and Imam Khomeini Hospitals, were enrolled. The patients were randomly divided into two groups: chest tube and pleuroscopy, using simple randomization. The mean and standard deviation, frequency and percentage, independent sample t-tests, chi-square, and Fisher’s exact tests were used for data analysis. A p-value of less than 0.05 was considered statistically significant. Results: No significant difference was observed between the two groups in the incidences of chest pain, fever, and both symptoms (p > 0.05). The treatment success rates among the chest tube and pleuroscopy cases were 83.3% and 100%, respectively, and there was no significant difference between the two groups (p = 0.05). Among the five patients who had a recurrence, four (80%) had lung cancer, and one (20%) had liver cancer, and this difference was significant (P = 0.003). Regarding the rate of response to the treatment according to the side with effusion, among the people who had a relapse, two people (40%) had right-sided effusion, and three others (60%) had left-sided effusion (P = 0.623). Conclusions: Both techniques were safe, had minor side effects, were transient, and easy to manage. However, the recurrence of the disease in the thoracoscopic pleurodesis method was significantly less than in the chest tube.