In a 38-patient randomised trial, thoracoscopic talc poudrage plus an indwelling pleural catheter achieved 89.5% 12-week pleurodesis versus 68.4% with talc alone and met the non-inferiority criterion. Median stay was one versus four days.
Key findings
- The pleurodesis difference was 21.1% (95% CI -4.0 to 46.1), whose lower bound exceeded -20%. Dyspnoea and stay favoured combination therapy; after ANCOVA, six-week dyspnoea and 12-week EQ-5D-5L utility remained significant, whereas VAS quality of life did not.
Why this matters globally
If confirmed, the combined approach could reduce bed use and return patients with advanced cancer home sooner while preserving effusion control, relevant to capacity-constrained systems.
Thai researcher contribution
A Thai collaboration across the Red Cross, Chulalongkorn University, King Chulalongkorn Memorial Hospital and Phramongkutklao Hospital designed and ran the randomised clinical study.
Limitations to consider
Only 19 patients per arm produced wide confidence intervals. Baseline symptom and QoL imbalance, plus retrospective trial registration, warrant caution and larger multicentre confirmation.