Which is the More Effective Option for Pleurodesis to Prevent the Recurrence of Malignant Pleural Effusion? Large-Particle Talc or Mistletoe Extract (ABNOVA Viscum Injection).

Background: Malignant pleural effusion affects many patients with advanced cancer. When chemotherapy or radiotherapy fails to relieve malignant pleural effusion and related symptoms, drainage and pleurodesis can help. Although surgical talc pleurodesis is the most widely used method, , which has been recently used in surgical or bedside procedures, has demonstrated significant results and is as effective as talc. This study aimed to determine the most effective agent and procedure.

Methods: Between January 2015 and July 2022, chemical pleurodesis was performed in 137 patients with malignant pleural effusion, using a surgical procedure in 48, a bedside procedure in 55, and a talc surgical procedure in 34 patients. We reviewed patients' clinical responses and disease progression after chemical pleurodesis.

Results: The success rate was not significantly different among the surgical procedures (91.7%), bedside procedures (83.6%), and talc surgical procedures (91.2%). However, the total drainage amount and tube insertion duration in both groups were more effective than those in the talc group. Furthermore, the bedside group showed significantly lower post-pleurodesis pain scores than the other 2 groups.

Conclusion: According to our results, talc and can be considered ideal agents for chemical pleurodesis. However, pleurodesis showed safer outcomes in terms of ensuring quality of life than talc. Additionally, the bedside group showed significantly lower pain scores than the other groups. Hence, patients for whom surgical procedures are inappropriate can undergo bedside pleurodesis without diminishing the therapeutic effect.