Efficacy and safety of talc pleurodesis for malignant pleural effusion: a meta-analysis

Talc pleurodesis has been widely used to control malignant pleural effusion; however, it is still not clear whether talc pleurodesis is more effective than other local therapies. We performed a meta-analysis to evaluate the efficacy and safety of talc pleurodesis in the management of malignant pleur...

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Bibliographic Details
Published in:PloS one 2014-01, Vol.9 (1), p.e87060-e87060
Main Authors: Xia, Huan, Wang, Xiao-Juan, Zhou, Qiong, Shi, Huan-Zhong, Tong, Zhao-Hui
Format: Article
Language:English
Subjects:
Analysis
Biology
Breast cancer
Cancer
Catheters
Clinical trials
Complications and side effects
Confidence intervals
Critical care
Dyspnea
Hospitals
Humans
Iodine
Life span
Mathematical models
Medical prognosis
Medicine
Meta-analysis
Models, Statistical
Ostomy
Patients
Pleural effusion
Pleural Effusion, Malignant - drug therapy
Pleurodesis - methods
Pleurodesis - standards
Quality of life
Risk
Risk assessment
Risk management
Safety
Slurries
Statistical analysis
Studies
Talc
Talc - therapeutic use
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Summary:Talc pleurodesis has been widely used to control malignant pleural effusion; however, it is still not clear whether talc pleurodesis is more effective than other local therapies. We performed a meta-analysis to evaluate the efficacy and safety of talc pleurodesis in the management of malignant pleural effusion. PubMed, Embase, and Web of Science were searched for English-language studies of clinical controlled trials comparing talc pleurodesis with control therapies until August 8, 2013. Success rate and incidence of adverse events were evaluated. Relative risks were estimated using random- or fixed- effects model and statistical heterogeneity was assessed using I² test. Twenty trials involving 1,525 patients with malignant pleural effusion were included. The success rate of talc pleurodesis was significantly higher than that of control therapies (relative risk, 1.21; 95% confidence interval, 1.01-1.45; p = 0.035) with similar adverse events. In addition, thoracoscopic talc poudrage was more effective than bedside talc slurry (relative risk, 1.12; 95% confidence interval, 1.01-1.23; p = 0.026). The current evidences suggested the benefit for talc pleurodesis in the treatment of malignant pleural effusion. Talc pleurodesis, especially thoracoscopic talc poudrage pleurodesis, should be performed in patients with malignant pleural effusion, especially those with life-expectancy longer than one month.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0087060