Intrapleural Mechlorethamine Hydrochloride Therapy for Malignant Pleural Effusion

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Abstract
PLEURAL EFFUSION secondary to metastatic malignant disease in pleura is a frequent occurrence. Particularly susceptible patients are those with primary breast cancer. Often the pleural effusion is the most symptomatic evidence of metastases. Systemic hormonal therapy or chemotherapy seldom alleviates the fluid accumulation and local treatment, therefore, must frequently be utilized. Various techniques of local intrapleural therapy have been devised, almost all of which are based on direct tumor destruction and/or creation of an obliterative, inflammatory pleural reaction. Such agents as radioactive colloidal gold and external radiation have been used with varying degrees of success, but with a relatively high complication rate. Parietal pleurectomy, a surgical procedure of some magnitude, has also been advocated as the procedure of choice.1 These approaches are all palliative, since the therapy obviously does not lead to cure. Development of alkylating agents has opened a new avenue of approach to the palliation of metastatic

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