Neoplastic pericardial disease in lung cancer: Impact on outcomes of different treatment strategies. A multicenter study

Lestuzzi, Chiara; Bearz, Alessandra; Lafaras, Christos; Gralec, Renata; Cervesato, Eugenio; Tomkowski, Witold; DeBiasio, Marzia; Viel, Elda; Bishiniotis, Theodoros; Platogiannis, Dimitrios; Buonadonna, Angela; Tartuferi, Lucia; Piazza, Rita; Tumolo, Salvatore; Berretta, Massimiliano; Santini, Francesco; Imazio, Massimo

doi:10.1016/j.lungcan.2010.10.013

Cited by 46 publications

(51 citation statements)

References 47 publications

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“…Cisplatin administered intrapericardially was effective in 98% of the cases (other medications only in 80%). The authors concluded that intrapericardial chemotherapy provided good control of pericarditis in 92% of cases, and a complete resolution in 65% (26). Our current study confirms that intrapericardial chemotherapy may be similarly effective for recurrent pericardial effusion in patients with hemodynamic instability and not only in patients with lung cancer or adenocarcinoma.…”

Section: Management Of the First Episode Of Cardiac Tamponadesupporting

confidence: 80%

Determinants of Survival After Emergency Intrapericardial Cisplatin Treatment in Cancer Patients with Recurrent Hemodynamic Instability After Pericardiocentesis

Darocha¹,

Wilk²,

Walaszkowska-Czyż³

et al. 2018

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. Conclusion: Efficacy of rescue intrapericardial chemotherapy with cisplatin is independent of parameters of hemodynamic instability and levels of inflammatory markers in recurrent pericardial effusion.Pericardial diseases constitute an infrequent, although very serious clinical problem among oncological patients. They practically always cause deterioration of the patient's quality of life. The increasing amount of pericardial effusion and the resulting cardiac tamponade is a life-threatening condition which requires urgent diagnostics and treatment.The European Society of Cardiology (ESC) Position Paper related to cardio-oncology summarizes the knowledge on acute and chronic pericarditis as the complication resulting from anticancer treatment: some cytotoxic drugs and radiotherapy (1). Experts indicate that pericardial complications in oncology are usually associated with mediastinal tumors occupying the pericardium. The document does not discuss the issue of pericardial effusion as a potential manifestation of malignant tumor progression. The present state of knowledge concerning malignant pericarditis is based on several retrospective studies and descriptions of small groups of patients. This article presents our own prospective experience related to the treatment of patients suffering from recurrent pericardial effusion and hemodynamic instability in the course of malignant disease.The primary purpose of the observation was the assessment of determinants of overall survival of oncological patients subject to emergency pericardiocentesis and intrapericardial chemotherapy with the use of cisplatin due to recurrent symptomatic pericardial effusion and cardiac tamponade.The detailed aims included the identification of factors which could have direct impact on the overall survival of patients, these included among others: complications of pericardiocentesis and cisplatin administered intrapericardially; signs of inflammatory process: pericardial effusion culture test results, fever, white blood cell count; hemodynamic conditions: baseline level of N-terminal pro-B type natriuretic peptide (NTproBNP), volume and duration of pericardial drainage; interval for recurrence pericardial effusion; possibility of further anticancer treatment. 373

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Section: Management Of the First Episode Of Cardiac Tamponadesupporting

confidence: 80%

Determinants of Survival After Emergency Intrapericardial Cisplatin Treatment in Cancer Patients with Recurrent Hemodynamic Instability After Pericardiocentesis

Darocha¹,

Wilk²,

Walaszkowska-Czyż³

et al. 2018

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“…Należy rozważyć doosierdziowe podanie cytostatyków/środków sklerotyzujących, ponieważ może to zapobiec nawrotowemu gromadzeniu się płynu u chorych z nowotworowym zajęciem osierdzia IIa B [197][198][199][200][201][202][203][204] W przypadku zajęcia osierdzia przez raka płuca należy rozważyć doosierdziowe podanie cisplatyny, a w przypadku przerzutów raka piersi -tiotepy IIa B [197,198,200,204] U pacjentów z nowotworami promieniowrażliwymi, np. chłoniakami czy białaczkami, należy rozważyć radioterapię w celu zmniejszenia produkcji płynu osierdziowego…”

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“…W celu zapobiegania gromadzeniu płynu można podać doosierdziowo środki sklerotyzujące i cytostatyki [197--204]. Leki stosowane doosierdziowo powinny być dobierane w zależności od rodzaju nowotworu: cisplatyna jest najbardziej skuteczna w przypadku zajęcia osierdzia przez raka płuca [200,204], a tiotepa w przypadku doosierdziowych przerzutów raka piersi [197,198]. Jako środek sklerotyzujący podaje się tetracykliny, które umożliwiają zmniejszenie produkcji płynu u ok. 85% chorych, ale leczenie często wiąże się z występowaniem działań niepożądanych i powikłań, w tym gorączki (19%), bólu w klatce piersiowej (20%) i przedsionkowych zaburzeń rytmu (10%) [189,199].…”

Section: Iia Bunclassified

2015 ESC Guidelines for the diagnosis and management of pericardial diseases

Adler

Charron²,

Imazio³

et al. 2015

Kardiol Pol

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“…A recently published study by Lestuzzi et al [45] was the first to compare the usefulness of the following different treatments of malignant pericardial disease in lung cancer: extended catheter drainage/sclerosis, systemic chemotherapy, local chemotherapy and combined local plus systemic chemotherapy. The authors analyzed 119 patients who were divided into subgroups depending on the treatment received.…”

Section: Management Of Malignant Pericardial Effusionmentioning

confidence: 99%

Malignant Pericardial Effusion

Burazor

Imazio

Markel³

et al. 2013

Cardiology

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Malignant pericardial effusion is a common and serious manifestation in malignancies. The origins of the malignant process include solid tumors or hematological malignancies, while primary neoplasms of the pericardium are less common. In the oncological patient, pericardial effusion may develop by several different mechanisms, namely by direct or metastatic spread of the primary process or as a complication of antineoplastic therapies. In some cases, pericardial effusion may be the first manifestation of the disease, and that is why malignancy must be excluded in every case of an acute pericardial disease with cardiac tamponade at presentation, rapidly increasing pericardial effusion and an incessant or recurrent course. Thus, the definite differentiation of malignant pericardial effusion and rapid diagnosis are of particular therapeutic and prognostic importance. Management of these patients is multidisciplinary and requires team work, but at present there is a need for further research. An individual treatment plan should be established, taking into account cancer stage, the patient's prognosis, local availability and experience. In emergency cases with cardiac tamponade or significant effusion, initial relief can be obtained with pericardiocentesis. Despite the magnitude of this serious problem, little progress has been made in the treatment of pericardial effusion secondary to malignant disease.

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Neoplastic pericardial disease in lung cancer: Impact on outcomes of different treatment strategies. A multicenter study

Cited by 46 publications

References 47 publications

Determinants of Survival After Emergency Intrapericardial Cisplatin Treatment in Cancer Patients with Recurrent Hemodynamic Instability After Pericardiocentesis

Determinants of Survival After Emergency Intrapericardial Cisplatin Treatment in Cancer Patients with Recurrent Hemodynamic Instability After Pericardiocentesis

2015 ESC Guidelines for the diagnosis and management of pericardial diseases

Malignant Pericardial Effusion

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