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.

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

Grant support

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.