Malignant pleural effusion is a common snd signigicant problem in patients with advanced malignancies. The optimal means of control are not defined. Pleurodesis with tetracycline or other sclerosing agents has been the usual treatment for malignant pleural effusions. Intracavitary cisplatin-based chemotherapy has been recently reported to be successful in some clinical trials for the purpose of controlling malignant exudate and favored by some authors because it is thought to be cytotoxic rather than sclerosing, that is, the potential advantage of treating the underlying malignancy in addition to controlling the effusion. This study evaluated intrapleural cisplatin and cytarabine combination chemotherapy in 15 patients with malignant pleural effusions from lung and other cancers. A single dose of cisplatin plus cytarabine was instilled into pleural space via a chest tube and drained 4 hours later. Systemic chemotheapy and/or radiation therapy were given at least 3 weeks apart after intrapleural chemotherapy if decided to recieve them. The outcome of this trial indicated that the intrapleural chemotherapy had high and durable treatment response(87%; CR 13 cases(81%)) and the median duration of response was 29 weeks which seemed long enough to be little maiignant pieural effusion in 7 cases among 9 patients followed up till moribund state. The procedures were tolerable in all the cases and chemothrapy induced complications were not significant.
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