phosphorus-radioisotopes and Pericardial-Effusion

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

A 68-yr-old male with agnogenic myeloid metaplasia was given phosphorus-32-colloidal chromic phosphate intrapericardially for the treatment of malignant pericardial effusion. Technetium-99m-sulfur colloid was used to verify catheter placement and to visualize distribution within the pericardium. Estimated dosimetry for this mode of therapy is presented, and it is suggested that pericardial administration of phosphorus-32-colloidal chromic phosphate is the treatment of choice for malignant pericardial effusion.

Topics: Aged; Chromium; Chromium Compounds; Colloids; Humans; Male; Pericardial Effusion; Phosphates; Phosphorus Radioisotopes; Primary Myelofibrosis

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

Pleural and peritoneal effusion secondary to primary malignancy is a significant problem in the management of the cancer patient. Respiratory embarrassment and discomfort associated with the formation and collection of fluid in the chest and abdomen are among the most distressing symptoms encountered as a result of malignant disease. The guidelines for treatment should be based on respiratory symptoms, and with the understanding that the procedure is palliative. Both surgical and medical forms of treatment have been used. These include thoracostomy-tube drainage alone or with the instillation of antimicrobial agents. Pleurectomy is effective but should be reserved for situations in which conservative approaches have failed. Antitumor agents, such as nitrogen mustard, are effective but toxic. The mode of action of antineoplastic agents is related to their ability to cause pleural sclerosis and obliterate the pleural space. Systemic chemotherapy and external beam radiation are rarely effective. The intracavitary application of radioactive colloids has been used since 1945. Colloidal radioactive gold Au 198 has been replaced by the pure beta emitter, colloidal chromic phosphate P 32. Instillation of a colloidal suspension of radioactive phosphorus represents a significant and effective palliative therapeutic modality for malignant effusion.

Topics: Adult; Ascites; Bleomycin; Colloids; Drainage; Female; Humans; Neoplasms; Palliative Care; Pericardial Effusion; Phosphorus Radioisotopes; Pleural Effusion; Pregnancy

Treatment of 28 patients with malignant pericardial effusion was accomplished primarily by intrapericardial instillation of radioactive chromic phosphate. At time of diagnosis of pericardial disease, 14 patients had major manifestations of tamponade; the rest had little or no clinical evidence of effusion. Only eight of the 28 patients had further problems with effusion after the initial pericardiocentesis and 32P instillation. Additional aspirations were done on those patients 2 weeks to 5 months later. The average survival was 9 months; seven patients lived more than 1 year.

Topics: Adult; Aged; Catheterization; Chromium; Female; Humans; Injections; Male; Middle Aged; Neoplasms; Pericardial Effusion; Phosphorus Radioisotopes

Topics: Heart Neoplasms; Humans; Pericardial Effusion; Phosphorus Radioisotopes