phosphorus-radioisotopes and Cardiac-Tamponade

Malignant pericardial effusion is usually treated only when signs of cardiac tamponade develop. Several methods of treatment have been reported with an overall response rate of approximately 75%. Since our initial study using intrapericardial 32P-colloid instillation as a treatment modality for pericardial effusion demonstrated a significant higher response rate, this study was conducted to further evaluate the efficacy of intrapericardial 32P-colloid in terms of response rates and duration of remissions. Intrapericardial instillation of 185-370 MBq (5-10 mCi) 32P-colloid in 36 patients with malignant pericardial effusion resulted in a complete remission rate of 94.5% (34 patients) whereas two patients did not respond to treatment due to a foudroyant formation of pericardial fluid. The median duration time was 8 months. No side-effects were observed. These results suggest that intrapericardial instillation of 32P-colloid is a simple, reliable and safe treatment strategy for patients with malignant pericardial effusions. Therefore, since further evidence is provided that 32P-colloid is significantly more effective than external radiation or non-radioactive sclerosing agents, this treatment modality should be considered for the management of malignant pericardial effusion.

Topics: Breast Neoplasms; Cardiac Tamponade; Chromium Compounds; Female; Gastrointestinal Neoplasms; Humans; Instillation, Drug; Lung Neoplasms; Lymphoma; Neoplasms; Pericardial Effusion; Phosphorus Radioisotopes; Radiopharmaceuticals

Treatment of 11 patients with malignant pericardial effusion was performed by instillation of radioactive phosphorus. All of these patients had clinical evidence of tamponade. Only 2 patients had further problems with effusion after radioisotope therapy. Remarkable long-lasting remission could be observed in the rest of patients.

Topics: Adult; Cardiac Tamponade; Female; Heart Neoplasms; Humans; Male; Middle Aged; Pericardial Effusion; Phosphorus Radioisotopes