The effect of iodopovidone versus bleomycin in chemical pleurodesis

Background: Malignant pleural effusion continues to be a common problem in patients with metastatic disease. This study was conducted to compare the efficacy and safety of bleomycin pleurodesis with povidone-iodine pleurodesis through a chest drain as palliative treatment for recurrent malignant pleural effusion. Methods: Sixty cancer patients (36 males and 24 females) with recurrent malignant pleural effusion were enrolled in a prospective randomized trial. Thirty patients received povidone-iodine pleurodesis and 30 received bleomycin pleurodesis. Age, sex, side of the primary pathology, treatment outcome (recurrence and relapse time), and complications were analyzed. Results: The mean age was 59.63 ± 7.68 years in the povidone-iodine group and 57.97 ± 9.27 years in the bleomycin group (p = 0.452). The complications were identical in both groups: 2 (6.7) patients had chest pain, 2 (6.7) had fever, and one (3.3) had hypotension. There was a good response to therapy in 20 (66.7) patients in the bleomycin group and 25 (83.3) in the povidone-iodine group (p = 0.136). Conclusion: The results of this study indicate that povidone-iodine should be considered as a selective chemical agent to perform pleurodesis in patients with recurrent malignant pleural effusion because it has the same effect but costs less than bleomycin. © 2018, The Author(s) 2018