A simple technique to manage malignant pericardial effusion with a local instillation of bleomycin in non-small cell carcinoma of the lung.
To examine the efficacy of bleomycin on the local control of malignant pericardial effusion, we prospectively conducted a clinical trial consisting of continuous pericardial drainage and a local instillation of bleomycin. In the current study, we treated 7 patients, who suffered from malignant pericardial effusion with cardiac tamponade due to advanced-stage non-small cell carcinoma of the lung. The pericardial effusions were continuously drained through an echo-guided inserted catheter. After the effusions were drained as completely as possible, 5 mg of bleomycin were instilled locally via the catheter. In all patients but one, the draining catheter could be successfully removed. The duration of drainage ranged from 4 to 13 days (mean: 9.2 days). Five of the 7 patients achieved a complete remission of pericardial effusions, which was maintained until death or the last day of follow-up. Intrapericardial bleomycin treatment was thus found to be effective on malignant pericardial effusions without any adverse effects. However, a further study comparing the effect of pericardial instillation of bleomycin versus drainage alone would be needed for the determination of the usefulness of bleomycin.
Yano
T
T
Department of Chest Surgery, National Kyushu Cancer Center, Fukuoka, Japan.
Yokoyama
H
H
Inoue
T
T
Takanashi
N
N
Asoh
H
H
Ichinose
Y
Y
D000368:Aged; D001761:Bleomycin / Q000008:administration & dosage*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy*; D004322:Drainage; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000188:drug therapy*; D011446:Prospective Studies
D001761:Bleomycin