Pleural effusions are common in patients with cancer
and cause a significant morbidity. The optimal treatment for the control of pleural effusions is not defined.
In patients with drug-sensitive tumors (e.g. breast cancer, lymphomas, small-cell lung cancer) systemic chemotherapy is the treatment of choice. For patients with
other solid tumors and in recurrences despite systemic
chemotherapy, the optimal treatment consists of thoracostomy-tube drainage with the instillation of a sclerosing agent [3]. Several agents are used to achieve pleuorodesis: tetracycline, bleomycin, quinacrine, nitrogen
mustard, doxorubicin, mitoxantrone and talc [7]. Mitoxantrone shows a steep dose/effect relationship for
different human tumor cell lines in vitro, and is a drug
well tolerated locally [2]. Whilst the usual dose of mitoxantrone for intrapleural therapy is 30 mg [6], we increased the dose to 40 mg.
