[Radiation-induced pericarditis. Long-term outcome. 45 cases with thoracotomy and biopsy]

Between 1970 and 1989, 45 cases of pericarditis consecutive to thoracic irradiation for cancer were studied to determine their long-term outcome and the course of their pericardial lesions. All patients were symptomatic and required surgery on account of cardiac dysfunction or, more rarely, for diagnostic purposes, i.e. to distinguish between pure autonomous pericardial complications and recurrent mediastinal neoplasias, the latter being excluded from the study. All patients were explored by thoracotomy which permitted histopathological examination of the pericardium and the pericardial fluid, at the same time as therapeutic surgery (pericardial decortication for constriction in 22 cases, creation of pleuro-pericardial windows to ensure drainage of major effusions in 23 cases). The outcome was often poor owing to associated post-radiotherapy myocardial and pulmonary lesions: there were 20 deaths, 5 of which were directly due to the neoplasia and 13 to the radiotherapeutic complications; 5 patients remained with impaired cardiorespiratory function.