Effusions into the pleural, peritoneal, or pericardial cavities as a result of metastatic malignancies may be distressing and disabling but are not necessarily immediately fatal. Direct instillation of radioactive colloidal gold is effective in 50 to 67% of cases in decreasing or eliminating the reaccumulation of fluid.1 There are, however, several disadvantages to the use of radioactive gold. Thus, special facilities are required for its use, and it is difficult to handle. It has a short half-life, it is not universally available, and it is expensive to the patient. In addition, it represents a potential radiation hazard to the patient, doctors, nurses, and technicians. Routine use of radioactive gold therapy is therefore not feasible in most hospitals.
Several reports have shown that direct instillation of nitrogen mustard into malignant effusions may also be effective in decreasing or eliminating reaccumulation of fluid.2 Experience with use of this drug in
Weisberger AS, Levine B, Storaasli JP. USE OF NITROGEN MUSTARD IN TREATMENT OF SEROUS EFFUSIONS OF NEOPLASTIC ORIGIN. JAMA. 1955;159(18):1704-1707. doi:10.1001/jama.1955.02960350004002