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European Heart Journal 2002 23(20):1625-1631; doi:10.1053/euhj.2002.3328
Copyright © 2002 by the European Society of Cardiology.
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Neoplastic pericardial effusion. Efficacy and safety of intrapericardial treatment with cisplatin

B. Maischa,f1, A.D. Ristica, S. Pankuweita, A. Neubauerb and MollR. c

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.

References

  1. Mukai K, Shinkai T, Tominaga K, Shimosatto Y. The incidence of secondary tumours of the heart and pericardium: A 10 year study. Jpn J Clin Oncol. 1988;18:195–201[Abstract/Free Full Text]
  2. Posner MR, Cohen GI, Skarin AT. Pericardial disease in patients with cancer. Am J Med. 1981;71:407–413[CrossRef][ISI][Medline]
  3. Wilding G, Green HL, Longo DL, Urba WJ. Tumours of the heart and pericardium. Cancer Treat Rev. 1988;15:165–181[CrossRef][ISI][Medline]
  4. Spodick DH. Pericardial diseases. Braunwald E, Zipes DP, Libby P. Heart Disease. Philadelphia, London, Toronto, Montreal, Sydney, Tokyo: W.B. Saunders; 2001. p. 1823–1876
  5. Ziskind AA, Palacios IF. Percutaneous balloon pericardiotomy for patients with pericardial effusion and tamponade. Topol EJ. Textbook of Interventional Cardiology. Philadelphia: W.B. Saunders; 1999. p. 869–877
  6. Risti AD, Seferovié PM, Maksimovi R, Ostoji M. Percutaneous balloon pericardiotomy in neoplastic pericardial effusion. Seferovi PM, Spodick DH, Maisch B. Pericardiology: Contemporary answers to continuing challenges. Belgrade: Science; 2000. p. 427–438
  7. Aitini E, Cavazzini G, Pasquini E. Treatment of primary or metastatic pleural effusion with intracavitary cytosine arabinoside and cisplatin. A phase II study. Acta Oncol. 1994;33:191–194[ISI][Medline]
  8. Maisch B, Pankuweit S, Brilla C, et al. Intrapericardial treatment of inflammatory and neoplastic pericarditis guided by pericardioscopy and epicardial biopsy—results from a pilot study. Clin Cardiol. 1999;22:I17–22[ISI][Medline]
  9. Bindi M, Trusso M, Tucci E. Intracavitary cisplatin in malignant cardiac tamponade. Tumori. 1987;73:163–165[ISI][Medline]
  10. Pavon-Jimenez R, Garcia-Rubira JC, Garcia-Martinez JT, et al. Intrapericardial cisplatin for malignant tamponade. Rev Esp Cardiol. 2000;53:587–589[ISI][Medline]
  11. Tomkowski W, Szturmowicz M, Fijalkowska A, Filipecki S, Figura-Chojak E. Intrapericardial cisplatin for the management of patients with large malignant pericardial effusion. J Cancer Res Clin Oncol. 1994;120:434–436[CrossRef][ISI][Medline]
  12. Tomkowski WZ, Filipecki S. Intrapericardial cisplatin for the management of patients with large malignant pericardial effusion in the course of the lung cancer. Lung Cancer. 1997;16:215–222[CrossRef][ISI][Medline]
  13. Tomkowski WZ, Filipecki S. Intrapericardial administration of cisplatin in treatment of metastatic pericardial involvement in adenocarcinoma of the lung. Arch Chest Dis. 1997;52:221–224
  14. Tomkowski W, Szturmowicz M, Fijalkowska A, Burakowski J, Filipecki S. New approaches to the management and treatment of malignant pericardial effusion. Support Care Cancer. 1997;5:64–66[CrossRef][ISI][Medline]
  15. Fiorentino MV, Daniele O, Morandi P. Intrapericardial instillation of platin in malignant pericardial effusion. Cancer. 1988;62:1904–1906[CrossRef][ISI][Medline]
  16. Tondini M, Rocco G, Bianchi C, Severi C, Corbellini D. Intracavitary cisplatin (CDDP) in the treatment of metastatic pericardial involvement from breast and lung cancer. Monaldi Arch Chest Dis. 1995;50:86–88[Medline]
  17. Lestuzzi Ch, Viel E, Sorio R, Meneguzzo N. Local chemotherapy for neoplastic pericardial effusion [letter]. Am J Cardiol. 2000;86:1292[CrossRef][ISI][Medline]
  18. Beretta F, Martinelli G, Cavalli F, Marone C. Pericardial effusion in patients with malignant neoplasms. Schweiz Med Wochenschr. 1992;122:1517–1524[ISI][Medline]
  19. Bishiniotis TS, Antoniadou S, Katseas G, Mouratidou D, Litos AG, Balamoutsos N. Malignant cardiac tamponade in women with breast cancer treated by pericardiocentesis and intrapericardial administration of triethylenethiophosphoramide (thiotepa). Am J Cardiol. 2000;86:362–364[CrossRef][ISI][Medline]
  20. Colleoni M, Martinelli G, Beretta F. Intracavitary chemotherapy with thiotepa in malignant pericardial effusions: an active and well-tolerated regimen. J Clin Oncol. 1998;16:2371–2376[Abstract]
  21. Girardi LN, Ginsberg RJ, Burt ME. Pericardiocentesis and intrapericardial sclerosis: effective therapy for malignant pericardial effusions. Ann Thorac Surg. 1997;64:1422–1427[Abstract/Free Full Text]
  22. Martinoni A, Cipolla CM, Civelli M. Intrapericardial treatment of neoplastic pericardial effusions. Herz. 2000;25:787–793[CrossRef][ISI][Medline]
  23. Fukuoka M, Takada M, Tamai S, et al. Local application of anti-cancer drugs for the treatment of malignant pleural and pericardial effusion. Gan To Kagaku Ryoho. 1984;11:1543–1549[Medline]
  24. Lee LN, Yang PC, Chang DB. Ultrasound guided pericardial drainage and intrapericardial instillation of mitomycin C for malignant pericardial effusion. Thorax. 1994;49:594–595[Abstract]
  25. Liu G, Crump M, Goss PE, Dancey J, Shepherd FA. Prospective comparison of the sclerosing agents doxycycline and bleomycin for the primary management of malignant pericardial effusion and cardiac tamponade. J Clin Oncol. 1996;14:3141–3147[Abstract]
  26. van der Gaast A, Kok TC, van der Linden NH, Splinter TA. Intrapericardial instillation of bleomycin in the management of malignant pericardial effusion. Eur J Cancer Clin Oncol. 1989;25:1505–1506[CrossRef][ISI][Medline]
  27. Yano T, Yokoyama H, Inoue T, Takanashi N, Asoh H, Ichinose Y. A simple technique to manage malignant pericardial effusion with a local instillation of bleomycin in non-small cell carcinoma of the lung. Oncology. 1994;51:507–509[ISI][Medline]
  28. Cormican MC, Nyman CR. Intrapericardial bleomycin for the management of cardiac tamponade secondary to malignant pericardial effusion. Br Heart J. 1990;63:61–62[Abstract/Free Full Text]
  29. Davis S, Rambotti P, Grignani F. Intrapericardial tetracycline sclerosis in the treatment of malignant pericardial effusion: an analysis of thirty-three cases. J Clin Oncol. 1984;2:631–636[Abstract]
  30. Maher EA, Shepherd FA, Todd TJ. Pericardial sclerosis as the primary management of malignant pericardial effusion and cardiac tamponade. J Thorac Cardiovasc Surg. 1996;112:637–643[Abstract/Free Full Text]
  31. Salamon P, Berliner S, Shachner A, Pinkhas J. Tetracycline treatment for malignant pericardial effusion. Med Interne. 1989;27:73–74[Medline]
  32. Shepherd FA, Ginsberg JS, Evans WK, Scott JG, Oleksiuk F. Tetracycline sclerosis in the management of malignant pericardial effusion. J Clin Oncol. 1985;3:1678–1682[Abstract/Free Full Text]
  33. Shepherd FA, Morgan C, Evans WK, Ginsberg JF, Watt D, Murphy K. Medical management of malignant pericardial effusion by tetracycline sclerosis. Am J Cardiol. 1987;60:1161–1166[CrossRef][ISI][Medline]
  34. Norum J, Lunde P, Aasebo U, Himmelmann A. Mitoxantrone in malignant pericardial effusion. J Chemother. 1998;10:399–404[ISI][Medline]
  35. Primrose WR, Clee MD, Johnston RN. Malignant pericardial effusion managed with Vinblastine. Clin Oncol. 1983;9:67–70[ISI][Medline]
  36. Dempke W, Firusian N. Treatment of malignant pericardial effusion with 32P-colloid. Br J Cancer. 1999;80:1955–1957[CrossRef][ISI][Medline]
  37. Firusian N. 32P therapy of malignant pericardial effusions. Onkologie. 1980;3:12–17[ISI][Medline]
  38. Martini N, Freiman AH, Watson RC, Hilaris BS. Intrapericardial installation of radioactive chromic phosphate in malignant effusion. AJR Am J Roentgenol. 1977;128:639–641[Abstract]
  39. Sprengelmeyer JT, McDermott RL. Phosphorus-32-colloidal chromic phosphate: treatment of choice for malignant pericardial effusion. J Nucl Med. 1990;31:2034–2036[Abstract/Free Full Text]
  40. Lissoni P, Barni S, Tancini G. Intracavitary therapy of neoplastic effusions with cytokines: comparison among interferon alpha, beta and interleukin-2. Support Care Cancer. 1995;3:78–80[CrossRef][ISI][Medline]
  41. Imamura T, Tamura K, Takenaga M, Nagamoto Y, Ishikawa T, Nakagawa S. Intrapericardial OK-432 instillation for the management of malignant pericardial effusion. Cancer. 1991;68:259–263[CrossRef][ISI][Medline]
  42. Keane D, Jackson G. Managing recurrent malignant pericardial effusions. Br Med J. 1992;305:729–730[ISI][Medline]
  43. Tulleken JE, Kooiman CG, van der Werf TS, Zijlstra JG, de Vries EG. Constrictive pericarditis after high-dose chemotherapy. Lancet. 1997;350:1601[ISI][Medline]
  44. Kahles H, Bastian HJ, Schiffmann O, Geck M, Helmke FR, Golz N. Mitoxantrone-induced acute left heart failure after intrapleural administration. Herz. 1997;22:217–220[ISI][Medline]
  45. Seferovi PM, Risti AD, Maksimovi R. Treatment of neoplastic pericardial effusion: Percutaneous balloon pericardiotomy vs. prolonged subxiphoid drainage (abstr). Eur Heart J. 2000;21:418

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