[Evaluation of intrapericardial cisplatin administration in cases of recurrent malignant pericardial effusion and cardiac tamponade]

Abstract

30 consecutive patients with large malignant pericardial effusion (MPE) entered this prospective study. After pericardiocentesis and insertion of a polyurethane catheter, pericardial fluid was drained. Malignant etiology of pericardial fluid was confirmed by cytological examination. After confirmation of MPE cisplatin (10 mg in 20 ml normal saline) was instilled over 5 minutes during 5 consecutive days directly into pericardial space. If fluid reaccumulation occurred the courses were repeated every 3 weeks. Treatment was considered successful if the patient with malignant effusion survived 30 days without recurrence of symptoms of large pericardial effusion and other interventions directed to the pericardium were required. Positive effect of intrapericardial treatment with cisplatin was achieved in 18 cases (60%). Mean period of response was 3, 7 months (+/-6). Cisplatin administered directly into pericardial space is effective and safe method of treatment of recurrent MPE. Sclerosis of the pericardial space is rare complication connected with CP. Positive effect of CP can depend on improvement of lymphatic drainage from heart. CP seems to be method of choice in intal intrapericardial treatment in patients with malignant cardiac tamponade and recurrent MPE in course of lung cancer.