Prospective Randomized Trial of Silver Nitrate vs Talc Slurry in Pleurodesis for Symptomatic Malignant Pleural Effusions.

This article cites a study comparing the efficacy and the safety of talc slurry and silver nitrate (SN) in the treatment of symptomatic malignant pleural effusions (MPE). It was hypothesized that the two agents would be equally effective. Sixty patients with unilateral MPEs were enrolled into this study. The patients were recruited between January 2000 and July 2002 from the following two hospitals: AVG Cancer Institute and Perola Byington Hospital. Eleven of the patients did not return for their follow-up visit and were excluded from the analysis. For the remaining 49 patients, a diagnosis of malignancy was obtained via cytology in 35 patients, by histologic examination of pleural biopsy specimens in 14 patients, and by both in 3 patients. In all patients, a chest tube was inserted using local anesthesia and parenteral meperidine. Findings of the study suggest that SN is an effective agent for producing a pleurodesis. The side effects of 0.5% SN appeared to be minimal.