A SIMPLE TECHNIQUE TO MANAGE MALIGNANT PERICARDIAL-EFFUSION WITH A LOCAL INSTILLATION OF BLEOMYCIN IN NONSMALL CELL-CARCINOMA OF THE LUNG

To examine the efficacy of bleomycin on the local control of malignant pericardial effusion, we prospectively conducted a clinical trial con sisting of continuous pericardial drainage and a local instillation of bleomycin. In the current study, we treated 7 patients, who suffered from malignant pericardial effusion with cardiac tamponade due to adva nced-stage non-small cell carcinoma of the lung. The pericardial effus ions were continuously drained through an echo-guided inserted cathete r. After the effusions were drained as completely as possible, 5 mg of bleomycin were instilled locally via the catheter. In all patients bu t one, the draining catheter could be successfully removed. The durati on of drainage ranged from 4 to 13 days (mean: 9.2 days). Five of the 7 patients achieved a complete remission of pericardial effusions, whi ch was maintained until death or the last day of follow-up. Intraperic ardial bleomycin treatment was thus found to be effective on malignant pericardial effusions without any adverse effects. However, a further study comparing the effect of pericardial instillation of bleomycin v ersus drainage alone would be needed for the determination of the usef ulness of bleomycin.