Abstract 1599P
Background
Malignant pericardial effusion (MPE) is a life-threatening complication in solid organ malignancies. Pericardiocentesis is mandatory when haemodynamic instability occurs, but there is still a lack of consensus regarding the utility of intrapericardial chemotherapy instillation.
Methods
We conducted a retrospective study including all the patients who underwent through cisplatin intrapericardial infusion between 2009 and 2021. The aim of the study was to assess the security and the effectiveness of the procedure to prevent pericardial effusion recurrences.
Results
Thirty-seven patients were included, seventeen (46%) of them female, with a mean age of 60 years old at the time of MPE diagnosis. 86.5% of the patients were metastatic at diagnosis and MPE was already present in 43% of them. The most frequent cancer was lung (86.5%), mostly non-small cell cancer (81% NSCLC) followed by breast (8%). The main symptom at time of presentation of MPE requiring pericardiocentesis was dyspnoea (73%). Clinical or echocardiographic tamponade was present in 89% of the patients and 38% required intensive care unit admission. Complications related to the pericardiocentesis occurred in a 13.5% of patients, being atrial fibrillation (AF) the most common (3 out of 5 patients). After pericardiocentesis, according to local protocol, 10mg of cisplatin were instilled using the pericardial catheter a median of 4 times (range 1-5). Nine patients (24.5%) experienced adverse events related to cisplatin infusion, most of them (89%) during the first 5 days (4 AF, 3 chest pain, 1 sinusal tachycardia and 1 nausea). No fatal or life-threatening events occurred. The mean survival after the diagnosis of MPE requiring pericardiocentesis was 442 days. Only 2 patients (5.5%) presented MPE recurrence during the follow-up, both of them in the first month.
Conclusions
Intrapericardial cisplatin seems to be safe for MPE since adverse events related to pericardiocentesis or drug instillation occurred only in 13.5% and 24.5% of the patients, respectively, none of them being life-threatening. Only 5.5% of the patients presented significant MPE recurrence, which suggests it might be an effective treatment.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.