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

Huan Xia; Xiao-Juan Wang; Qiong Zhou; Huan-Zhong Shi; Zhao-Hui Tong

doi:10.1371/journal.pone.0087060

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

PLoS One. 2014 Jan 27;9(1):e87060. doi: 10.1371/journal.pone.0087060. eCollection 2014.

Authors

Huan Xia¹, Xiao-Juan Wang¹, Qiong Zhou², Huan-Zhong Shi³, Zhao-Hui Tong¹

Affiliations

¹ Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Beijing Institute of Respiratory Medicine, Capital Medical University, Beijing, China.
² Department of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
³ Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Beijing Institute of Respiratory Medicine, Capital Medical University, Beijing, China ; Center of Medical Research, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.

Abstract

Background: 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.

Methods: 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.

Results: 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).

Conclusions: 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.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't

MeSH terms

Humans
Models, Statistical
Pleural Effusion, Malignant / drug therapy*
Pleurodesis / methods
Pleurodesis / standards*
Risk
Talc / therapeutic use*

Substances

Talc

Grants and funding

This work was supported in part by a grant from the Beijing High-Grade Talents Health Technology Fund (NO. 2011-2-06) and in part by a grant from Beijing Municipal Science & Technology Commission (NO. Z131107002213107). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.