Regular Article

British Journal of Cancer (2000) 83, 858–862. doi:10.1054/bjoc.2000.1397 www.bjcancer.com
Published online 5 September 2000

Controlling malignant pericardial effusion by intrapericardial carboplatin administration in patients with primary non-small-cell lung cancer

T Moriya1, Y Takiguchi1, H Tabeta2, R Watanabe1, H Kimura1, K Nagao3 and T Kuriyama1

  1. 1Department of Chest Medicine, Chiba University School of Medicine, Chiba, Japan
  2. 2Department of Chest Medicine, Funabashi Medical Center, Funabashi, Japan
  3. 3Health Sciences Center, Chiba University, Chiba, Japan

Received 7 December 1999; Revised 26 June 2000; Accepted 4 July 2000.

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Abstract

Malignant pericarditis, when associated with massive pericardial effusion, presents a critical condition in lung cancer patients. Because this condition often arises in terminally ill patients, intensive therapy such as multi-drug combination chemotherapy is rarely appropriate. This study evaluated the clinical relevance of intrapericardial administration of carboplatin for controlling malignant pericardial effusions associated with non-small-cell lung carcinoma (NSCLC). The method used for 10 eligible patients consisted of draining the pericardial effusion and infusing 300 mg/body of carboplatin in 50 ml of saline through an in-place catheter into the pericardial space and clamping the catheter for 40 min. Nine of the 10 patients showed satisfactory results, and 8 experienced complete regression of the effusion. No major or minor adverse effects were observed. Pharmacokinetics analysis revealed that the concentration of free platinum in the pericardial fluid was very high while that of total platinum in the circulating plasma was very low, assuring the usefulness of the intrapericardial instillation of carboplatin in terminally ill patients for controlling malignant pericardial effusion when the systemic delivery of cytotoxic agents is inappropriate. © 2000 Cancer Research Campaign

Keywords:

cardiac tamponade, pericardial effusion, malignant pericarditis, lung cancer, carboplatin, pharmacokinetics

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