Intracavitary therapy with bleomycin for the treatment of malignant pleural effusions.

This paper briefly reviews the incidence of malignant pleural effusions (MPE) and the measures that have been used to treat this condition. The role of intracavitary bleomycin in controlling MPE, the doses used, and morbidity associated with its use are reviewed in depth with reference to multicenter studies that the author has coordinated as well as the published literature. The short- and long-term results reported when bleomycin was used alone or as compared with other agents are discussed. The author concludes that intracavitary bleomycin is an effective agent comparable to, if not more effective than, most agents used to prevent the recurrence of MPE after simple drainage procedures: it is safe and convenient to use; toxicity is low with minimal side effects and no myelosuppression. It can be safely administered to immunocomprised patients and those undergoing systemic chemotherapy.