The aim of this study was to evaluate the effectiveness and side-effects of intrapericardial administration of
cisplatin (IAC), in cases of abundant malignant
pericardial effusion (MPE) and/or
cardiac tamponade occurring in the course of
adenocarcinoma of the lung (AL). Fifteen consecutive patients with abundant MPE and AL (4 females and 11 males; mean age 54 yrs) entered this prospective study. Following pericardiocentesis and insertion of a
polyurethane catheter, the pericardial fluid was drained. Malignant aetiology of the pericardial fluid was confirmed by cytological examination. After confirmation of MPE,
cisplatin (10 mg in 20 mL
normal saline) was instilled directly into the pericardial space, over a period of 5 min for 3-5 consecutive days. Treatment was considered successful (response) if the patient survived 30 days without recurrence of symptoms of abundant MPE, and no other interventions directed to the pericardium were required. Response was achieved in 10 patients (67%). The mean (+/-SEM) dose of
cisplatin was 56 (+/-18.9) mg. There were no complications related to the pericardiocentesis. Transient
atrial fibrillation was detected in one patient. Mild
nausea also occurred in one case. No
hypotension or retrosternal
pain was observed. Sclerotization of the pericardium and
pericarditis constrictiva were detected after IAC in only one case.
Cisplatin administered directly into pericardial space is effective and safe. Intraperitoneal administration of
cisplatin appears to be the method of choice in the treatment of recurrent
malignant pleural effusion in patients with primary
adenocarcinoma of the lung.
Sclerosis of the pericardial space is a very rare complication observed after intraperitoneal administration of
cisplatin therapy.