Abstract | OBJECTIVE: Pericardial involvement is a common feature in different neoplastic diseases, having a strong influence on the natural history of the disease and on the quality of life of the patients. This study was performed in order to investigate the long-term effects of intracavitary treatment with thiotepa in the reduction of pericardial effusion (PE) recurrences. DESIGN: Prospective controlled intervention study. SETTING: European Institute of Oncology, Milan, Italy. PATIENTS: INTERVENTION: All patients with large PE, with or without cardiac tamponade, underwent percutaneous pericardiocentesis (PC) under echocardiographic monitoring. Patients with neoplastic cells in drained fluid were considered to be eligible for treatment. After drainage, the catheter was maintained in the pericardial sac for the instillation of a sclerosing, alkylating antiblastic agent ( thiotepa) on days 1, 3, and 5 after the PC (15 mg at each step). RESULTS: No procedure-related complications or side effects were observed. Two patients died because of disease progression, without PE evidence. No PE occurred in the remaining patients during the first month. Three recurrences occurred (9.1%), requiring additional PC and intrapericardial treatment. The median survival time was 115 days (range, 22 to 1,108 days) in the overall population, and 272 days in patients with breast cancer. CONCLUSIONS: Intrapericardial treatment with thiotepa carries a minimal risk and is a repeatable procedure that can dramatically increase quality of life, or even can improve survival and the natural history of disease in cancer patients.
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Authors | Alessandro Martinoni, Carlo Maria Cipolla, Daniela Cardinale, Maurizio Civelli, Giuseppina Lamantia, Marco Colleoni, Cesare Fiorentini |
Journal | Chest
(Chest)
Vol. 126
Issue 5
Pg. 1412-6
(Nov 2004)
ISSN: 0012-3692 [Print] United States |
PMID | 15539706
(Publication Type: Clinical Trial, Controlled Clinical Trial, Journal Article, Review)
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Chemical References |
- Antineoplastic Agents, Alkylating
- Thiotepa
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Topics |
- Antineoplastic Agents, Alkylating
(administration & dosage)
- Combined Modality Therapy
- Female
- Follow-Up Studies
- Humans
- Instillation, Drug
- Male
- Neoplasms
(complications, drug therapy)
- Pericardial Effusion
(etiology, therapy)
- Pericardiocentesis
- Prospective Studies
- Thiotepa
(administration & dosage)
- Time Factors
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