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Malignant pleural effusions can cause disabling dyspnea and chest pain. Traditional treatment has been drainage and pleurodesis; however, use of small indwelling pleural catheters has increased recently. It is unclear which procedure produces better symptom relief.
In this multicenter U.K. trial, 106 patients with malignant pleural effusions were randomized to talc pleurodesis or catheter placement. During the first 42 days, patients in both groups had similar significant improvements in dyspnea. At 6 months, the catheter group had significantly better dyspnea scores (a 14-mm difference on a 100-mm visual analog scale), but it is noteworthy that only 54 patients were included in this analysis, as nearly half the patients had died. Patients i…