Intracavitary adriamycin nitrogen mustard and tetracycline in the control of malignant effusions. A randomized study

Thirty-eight patients with symptomatic histologically confirmed malignant effusions (26 pleural, 11 peritoneal, one pericardial) who were not receiving concurrent chemotherapy or radiotherapy were randomized to receive intracavitary adriamycin 30 mg, nitrogen mustard 20 mg, or rolitetracycline 500 mg after maximal fluid aspirations. A total of 45 treatments were administered. Complete response was assessed as absence of significant effusions for eight weeks post-aspiration, and partial response as a reduction in the frequency of aspirations. Twelve of 15 (80%) effusions responded to adriamycin (three complete responses), 6/17 (35%) effusions responded to nitrogen mustard (no complete responses) and 7/13 (54%) effusions responded to rolitetracycline (one complete response) (P < 0.05). Toxicity was similar for all treatments. Intracavitary adriamycin is an effective agent in the palliation of malignant effusions, is superior to intracavitary nitrogen mustard and rolitetracycline, and is comparable in toxicity.