Copyright © 2002 by the European Society of Cardiology.
Neoplastic pericardial effusion. Efficacy and safety of intrapericardial treatment with cisplatin
a
a Department of Internal Medicine–Cardiology, Philipps University, Marburg, Germany
b Department of Internal Medicine–Haematology/Oncology, Philipps University, Marburg, Germany
c Department of Pathology, Philipps University, Marburg, Germany
revised June 11, 2002; accepted June 12, 2002
Abstract
Aims To evaluate the clinical efficacy, safety, and long-term effect of intrapericardial treatment with cisplatin in large neoplastic pericardial effusions.
Methods and Results Out of the registry of 260 patients undergoing pericardiocentesis, 42 patients with neoplastic pericardial effusion (69% males, mean age 58.8±13·2 years) were selected for treatment with cisplatin (single instillation of 30mg.m–2.24h–1) in addition to the tumour-specific systemic chemotherapy. All patients underwent clinical examination, echocardiography, pericardiocentesis, pericardioscopy, and epicardial biopsy. Pericardial effusion and biopsy analyses included biochemistry, cytology, serology, microbiology, histology, immunohistology, and PCR. The following malignancies were established: lung cancer, 52·4%; breast cancer, 19·0%; Hodgkin's disease, 4·8%; oesophageal cancer, 2·4%; mesothelioma, 2·4%; colon cancer, 4·8%; and undifferentiated cancer of unknown origin, 14·2%. Cisplatin appeared to prevent recurrence of pericardial effusion during the first 3 months of the follow-up in 92·8%, and after 6 months in 83·3% of the patients. Lung cancer patients had fewer effusion relapses at the 6 months follow-up (4·5%) than breast cancer patients (37·5%)(P<0·05). Myocardial ischemia occurred after 1/42 cisplatin instillations, but there were no other complications.
Conclusion Intrapericardial treatment with cisplatin appeared to successfully prevent recurrences of neoplastic pericardial effusion. The treatment was more successful in lung than in breast cancer patients.Copyright 2002 The European Society of Cardiology. Published by Elsevier Science Ltd. All rights reserved .
Key Words: Cisplatin, pericardium, pericarditis, pericardial effusion, tumours
f1 Correspondence: Prof. Dr Bernhard Maisch, FESC, FACC, Director, Dept. of Internal Medicine-Cardiology, Philipps University, Marburg, Baldingerstrasse 1, 35033 Marburg, Germany.
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