Sezai Çelik1, Chiara Lestuzzi2, Eugenio Cervesato3, Didier Dequanter4, Patrizia Piotti5, Marzia De Biasio6, Massimo Imazio7. 1. Department of Thoracic Surgery, Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey. Electronic address: siyamie@gmail.com. 2. Cardiology Unit, Department of Oncology Centro di Riferimento Oncologica National Cancer Institute, Aviano, Italy. 3. Department of Cardiology, ARC, S Maria Degli Angeli Hospital, Pordenone, Italy. 4. Department of Surgery, Centre Hospitalier Universitaire Charleroi, Montigny le Tielleuil, Belgium. 5. Department of Cardiology, Istituto Nazionale Tumori, National Cancer Institute, Milan, Italy. 6. Department of Cardiology, AOU S Maria Della Misericordia, Udine, Italy. 7. Department of Cardiology, Maria Vittoria Hospital, Turin, Italy.
Abstract
OBJECTIVE: Our aim was to compare systemic chemotherapy (CT) with drainage and with pericardial window in the treatment of neoplastic pericarditis in patients with various malignancies included in the International Neoplastic Pericarditis Treatment study. METHODS: Patients treated with systemic CT alone (Group A), CT plus drainage (Group B), or CT plus pericardial window (Group C) were included. Treatment response was defined as complete response (ie, no more pericardial effusion or masses), partial response (ie, reduced total score, without requiring further treatments), stable disease (ie, unchanged total score), or progressive disease (ie, increased total score). Patients with partial or complete response were considered responders. RESULTS: This preliminary report included 175 patients (56.6% male) with a mean age of 54.21±14.26 years. Gender distribution, age, and follow-up duration was similar for all groups (P>.05). Prevalent cancer types were lung cancer (50.9%), breast cancer (14.9%), and lymphoma/leukemia (14.9%). Overall, 22.3%, 42.9%, and 34.9% of patients were in treatment group A, B, and C, respectively. There were 132 responders (75.3%). The rate of responders significantly differed between groups (P<.001); it was significantly higher in Group B than in Group A (P<.05) and in Group C than in Group B (P=.006). The significant factors affecting response were therapy (P=.002) and extent of effusion (P=.037). Kaplan-Meier analysis showed that patients in Group C had a significantly better survival rate than patients in the other groups (P=.001). CONCLUSIONS: Systemic CT plus pericardial window is a more effective treatment option compared with systemic CT alone and systemic CT plus drainage in patients with malignant effusions.
OBJECTIVE: Our aim was to compare systemic chemotherapy (CT) with drainage and with pericardial window in the treatment of neoplastic pericarditis in patients with various malignancies included in the International Neoplastic Pericarditis Treatment study. METHODS:Patients treated with systemic CT alone (Group A), CT plus drainage (Group B), or CT plus pericardial window (Group C) were included. Treatment response was defined as complete response (ie, no more pericardial effusion or masses), partial response (ie, reduced total score, without requiring further treatments), stable disease (ie, unchanged total score), or progressive disease (ie, increased total score). Patients with partial or complete response were considered responders. RESULTS: This preliminary report included 175 patients (56.6% male) with a mean age of 54.21±14.26 years. Gender distribution, age, and follow-up duration was similar for all groups (P>.05). Prevalent cancer types were lung cancer (50.9%), breast cancer (14.9%), and lymphoma/leukemia (14.9%). Overall, 22.3%, 42.9%, and 34.9% of patients were in treatment group A, B, and C, respectively. There were 132 responders (75.3%). The rate of responders significantly differed between groups (P<.001); it was significantly higher in Group B than in Group A (P<.05) and in Group C than in Group B (P=.006). The significant factors affecting response were therapy (P=.002) and extent of effusion (P=.037). Kaplan-Meier analysis showed that patients in Group C had a significantly better survival rate than patients in the other groups (P=.001). CONCLUSIONS: Systemic CT plus pericardial window is a more effective treatment option compared with systemic CT alone and systemic CT plus drainage in patients with malignant effusions.
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