Intrapericardial instillation of platin in malignant pericardial effusion

Six patients (four men and two women) affected by malignant pericardial effusion, as confirmed by cytologic examination, were treated with direct intrapericardial administration of cisplatin. Median age was 36.8 years (range, 18 to 56 years). After insertion of a radiopaque polyurethane catheter (Centracath Vygon, Laboratoires Pharmaceutiques, Vygon-Ecouen, France), fluid was drained and cisplatin (10 mg in 20 ml of normal saline) was instilled over 5 minutes on 5 consecutive days (total cisplatin dose, 50 mg). At the end of the course, the catheter was withdrawn. Courses were repeated every 2 or 3 weeks in case of fluid reaccumulation. The median number of courses was two, with a range of one to three courses. Three patients achieved complete response and all three died of primary disease progression without evidence of pericardial recurrence or stricture. Mild nausea occurred in all patients. No hematologic and renal toxicity and local or infectious complications were observed.