Advertisement

Herz

pp 1–6 | Cite as

Management of neoplastic pericardial disease

  • J. Zhang
  • Q. Zhang
  • X. Chen
  • N. ZhangEmail author
Review articles

Abstract

At present, there is no accurate and effective method for treating neoplastic pericardial effusion. This study analyzed the current literature on the treatment of neoplastic pericardial effusion to provide advice and guidance for clinical treatment. Surgical treatments include pericardial puncture, extension of catheter drainage, pericardial window, and surgical pericardiotomy. Each surgical procedure has a corresponding indication, and the best treatment is selected according to the patient’s specific conditions. Systemic chemotherapy is effective in lymphoma and small cell lung cancer that are sensitive to chemotherapeutic drugs. Although pericardial injection of drugs is effective for pericardial tamponade and recurrent pericardial effusion, these methods can only temporarily relieve symptoms and cannot prolong the life of patients. In recent years, immunotherapy, especially adoptive immunotherapy, has achieved good results in the treatment of neoplastic pericardial effusion, thus providing a novel treatment option for neoplastic pericardial effusion.

Keywords

Neoplastic pericardial disease Pericardium Treatment management Cancer Immunotherapy 

Behandlung neoplastisch bedingter Erkrankungen des Perikards

Zusammenfassung

Gegenwärtig gibt es keine genaue und wirksame Methode zur Behandlung eines neoplastisch bedingten Perikardergusses. Für die vorliegende Arbeit wurde die neueste Literatur zur Behandlung neoplastischer Perikardergüsse analysiert, um Hinweise und Anleitungen für die klinische Behandlung zu geben. Chirurgische Behandlungsansätze umfassen die Perikardpunktion, länger ausgedehnte Katheterdrainage, Perikardfensterung und chirurgische Perikardiotomie. Jeder chirurgische Eingriff hat eine entsprechende Indikation, und die am besten geeignete Behandlung wird entsprechend den spezifischen Bedingungen des Patienten ausgewählt. Systemische Chemotherapie ist gegen Lymphome und kleinzellige Lungenkarzinome wirksam, wenn diese auf Chemotherapeutika ansprechen. Obwohl die perikardiale Injektion von Medikamenten bei Perikardtamponade und rezidivierendem Perikarderguss wirksam ist, können diese Verfahren die Symptome nur vorübergehend lindern und die Lebensdauer der Patienten nicht verlängern. In den letzten Jahren wurden durch die Immuntherapie, insbesondere die adoptive Immuntherapie, gute Ergebnisse bei der Behandlung des neoplastischen Perikardergusses erzielt, wodurch eine neuartige Behandlungsmöglichkeit für den neoplastisch bedingten Perikarderguss geschaffen wurde.

Schlüsselwörter

Neoplastisch bedingter Perikarderguss Perikard Behandlung Krebs Immuntherapie 

Notes

Compliance with ethical guidelines

Conflict of interest

J. Zhang, Q. Zhang, X. Chen and N. Zhang declare that they have no competing interests.

For this article no studies with human participants or animals were performed by any of the authors.

References

  1. 1.
    Mukai K, Shinkai T, Tominaga K, Shimosato Y (1988) The incidence of secondary tumors of the heart and pericardium: a 10-year study. Jpn J Clin Oncol 18(3):195–201PubMedGoogle Scholar
  2. 2.
    Taguchi S (2018) Comprehensive review of the epidemiology and treatments for malignant adult cardiac tumors. Gen Thorac Cardiovasc Surg 66(5):257–262PubMedCrossRefGoogle Scholar
  3. 3.
    Gromadziński L, Przelaskowski P, Januszko-Giergielewicz B et al (2013) Cardiac tamponade as the first symptom of lung cancer. Pneumonol Alergol Pol 81(2):149–153PubMedGoogle Scholar
  4. 4.
    Burazor I, Imazio M, Markel G, Adler Y (2013) Malignant pericardial effusion. Cardiology 124(4):224–232PubMedCrossRefGoogle Scholar
  5. 5.
    Virk SA, Chandrakumar D, Villanueva C, Wolfenden H, Liou K, Cao C (2015) Systematic review of percutaneous interventions for malignant pericardial effusion. Heart 101(20):1619–1626PubMedCrossRefGoogle Scholar
  6. 6.
    Imazio M, Adler Y (2013) Management of pericardial effusion. Eur Heart J 34(16):1186–1197PubMedCrossRefGoogle Scholar
  7. 7.
    Loukas M, Walters A, Boon JM, Welch TP, Meiring JH, Abrahams PH (2012) Pericardiocentesis: a clinical anatomy review. Clin Anat 25(7):872–881PubMedCrossRefGoogle Scholar
  8. 8.
    Salem K, Mulji A, Lonn E (1999) Echocardiographically guided pericardiocentesis—the gold standard for the management of pericardial effusion and cardiac tamponade. Can J Cardiol 15(11):1251–1255PubMedGoogle Scholar
  9. 9.
    Kennedy UM, Mahony NJ (2006) A cadaveric study of complications associated with the subxiphoid and transthoracic approaches to emergency pericardiocentesis. Eur J Emerg Med 13(5):254–259PubMedCrossRefGoogle Scholar
  10. 10.
    Maggiolini S, De Carlini CC, Imazio M (2018) Evolution of the pericardiocentesis technique. J Cardiovasc Med (hagerstown) 19(6):267–273CrossRefGoogle Scholar
  11. 11.
    Fitch MT, Nicks BA, Pariyadath M, McGinnis HD, Manthey DE (2012) Videos in clinical medicine. Emergency pericardiocentesis. N Engl J Med 366(12):e17PubMedCrossRefGoogle Scholar
  12. 12.
    Volk L, Ikegami H, Lee LY, Lemaire A (2018) Pericardial windows have limited diagnostic success. J Cardiothorac Surg 13(1):87PubMedPubMedCentralCrossRefGoogle Scholar
  13. 13.
    Spodick DH (1976) The pericardium: structure, function, and disease spectrum. Cardiovasc Clin 7(3):1–10PubMedGoogle Scholar
  14. 14.
    Allen KB, Faber LP, Warren WH, Shaar CJ (1999) Pericardial effusion: subxiphoid pericardiostomy versus percutaneous catheter drainage. Ann Thorac Surg 67(2):437–440PubMedCrossRefGoogle Scholar
  15. 15.
    Wagner PL, McAleer E, Stillwell E et al (2011) Pericardial effusions in the cancer population: prognostic factors after pericardial window and the impact of paradoxical hemodynamic instability. J Thorac Cardiovasc Surg 141(1):34–38PubMedCrossRefGoogle Scholar
  16. 16.
    El HD, Iliescu C, Yusuf SW et al (2015) Outcomes of cancer patients undergoing percutaneous pericardiocentesis for pericardial effusion. J Am Coll Cardiol 66(10):1119–1128CrossRefGoogle Scholar
  17. 17.
    Jong BH, Wei CC, Shyu KG (2016) Improved hyponatremia after pericardial drainage in patients suffering from cardiac tamponade. BMC Cardiovasc Disord 16:135PubMedPubMedCentralCrossRefGoogle Scholar
  18. 18.
    Adler Y, Charron P, Imazio M et al (2015) 2015 ESC Guidelines for the diagnosis and management of pericardial diseases: The Task Force for the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology (ESC)Endorsed by: The European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J 36(42):2921–2964PubMedCrossRefGoogle Scholar
  19. 19.
    Jama GM, Scarci M, Bowden J, Marciniak SJ (2014) Palliative treatment for symptomatic malignant pericardial effusion. Interact Cardiovasc Thorac Surg 19(6):1019–1026PubMedCrossRefGoogle Scholar
  20. 20.
    Hosomi Y, Ohkuma Y, Shibuya M (2008) Treatment of malignant pericardial effusion. Gan To Kagaku Ryoho 35(6):906–909PubMedGoogle Scholar
  21. 21.
    Olsen PS, Sørensen C, Andersen HO (1991) Surgical treatment of large pericardial effusions. Etiology and long-term survival. Eur J Cardiothorac Surg 5(8):430–432PubMedCrossRefGoogle Scholar
  22. 22.
    Altman E, Rutsky O, Shturman A, Yampolsky Y, Atar S (2015) Anterior parasternal approach for creation of a pericardial window. Ann R Coll Surg Engl 97(5):375–378PubMedPubMedCentralCrossRefGoogle Scholar
  23. 23.
    Schusler R, Meyerson SL (2018) Pericardial disease associated with malignancy. Curr Cardiol Rep 20(10):92PubMedCrossRefGoogle Scholar
  24. 24.
    Muhammad MI (2011) The pericardial window: is a video-assisted thoracoscopy approach better than a surgical approach. Interact Cardiovasc Thorac Surg 12(2):174–178PubMedCrossRefGoogle Scholar
  25. 25.
    Horr SE, Mentias A, Houghtaling PL et al (2017) Comparison of outcomes of pericardiocentesis versus surgical pericardial window in patients requiring drainage of pericardial effusions. Am J Cardiol 120(5):883–890PubMedCrossRefGoogle Scholar
  26. 26.
    Puri A, Agarwal N, Dwivedi SK, Narain VS (2012) Percutaneous balloon pericardiotomy for the treatment of recurrent malignant pericardial effusion. Indian Heart J 64(1):88–89PubMedPubMedCentralCrossRefGoogle Scholar
  27. 27.
    Navarro DALF, Córdoba PM, Orejas OM, López FT, Mohandes M, Iñíguez RA (2002) Percutaneous balloon pericardiotomy in patients with recurrent pericardial effusion. Rev Esp Cardiol 55(1):25–28CrossRefGoogle Scholar
  28. 28.
    Bhardwaj R, Gharib W, Gharib W, Warden B, Jain A (2015) Evaluation of safety and feasibility of percutaneous balloon pericardiotomy in hemodynamically significant pericardial effusion (review of 10-years experience in single center). J Interv Cardiol 28(5):409–414PubMedCrossRefGoogle Scholar
  29. 29.
    Irazusta FJ, Jiménez-Valero S, Gemma D et al (2017) Percutaneous balloon pericardiotomy: treatment of choice in patients with advanced oncological disease and severe pericardial effusion. Cardiovasc Revasc Med 18(5S1):S14–S17PubMedCrossRefGoogle Scholar
  30. 30.
    Kilicaslan B, Susam I, Dursun H, Ekmekci C, Aydin M, Ozdogan O (2013) Percutaneous balloon pericardiotomy using the Inoue balloon for patients with recurrent pericardial tamponade. Cardiovasc J Afr 24(4):e10–2PubMedCrossRefGoogle Scholar
  31. 31.
    Ruiz-García J, Jiménez-Valero S, Moreno R et al (2013) Percutaneous balloon pericardiotomy as the initial and definitive treatment for malignant pericardial effusion. Rev Esp Cardiol 66(5):357–363PubMedCrossRefGoogle Scholar
  32. 32.
    Osuch JR, Khandekar JD, Fry WA (1985) Emergency subxiphoid pericardial decompression for malignant pericardial effusion. Am Surg 51(6):298–300PubMedGoogle Scholar
  33. 33.
    Sakanoue I, Hamakawa H, Okubo Y et al (2016) Efficacy and safety of thoracoscopic pericardial window in patients with pericardial effusions: a single-center case series. J Cardiothorac Surg 11(1):92PubMedPubMedCentralCrossRefGoogle Scholar
  34. 34.
    Han AJ, Slomka T, Mehrotra A, Murillo LC, Alsafwah SF, Khouzam RN (2016) Paradoxical Hemodynamic instability after pericardial window. Echocardiography 33(8):1251–1252PubMedCrossRefGoogle Scholar
  35. 35.
    Chung J, Ocken L, Wolo E, Herman CR, Goldhammer JE (2018) Acute right ventricular failure after surgical drainage of pericardial tamponade: a case report of pericardial decompression syndrome and review of the literature. J Cardiothorac Vasc Anesth 33(3):768–771PubMedCrossRefGoogle Scholar
  36. 36.
    Kazantzis T, Bibas BJ, Dela-Vega AJ et al (2019) Predictors of hospital discharge in cancer patients with pericardial effusion undergoing surgical pericardial drainage. J Surg Oncol 119(1):143–147PubMedCrossRefGoogle Scholar
  37. 37.
    Jain RK (2012) Delivery of molecular and cellular medicine to solid tumors. Adv Drug Deliv Rev 64(Suppl):353–365.  https://doi.org/10.1016/j.addr.2012.09.011 PubMedPubMedCentralCrossRefGoogle Scholar
  38. 38.
    Hanafy AF, El-Egaky AM, Mortada SA, Molokhia AM (2009) Development of implants for sustained release of 5‑fluorouracil using low molecular weight biodegradable polymers. Drug Discov Ther 3(6):287–295PubMedGoogle Scholar
  39. 39.
    Lestuzzi C, Lafaras C, Bearz A et al (2009) Malignant pericardial effusion: sclerotherapy or local chemotherapy. Br J Cancer 101(4):734–735 (author reply 736–7)PubMedPubMedCentralCrossRefGoogle Scholar
  40. 40.
    Coburn JM, Kaplan DL (2015) Engineering biomaterial-drug conjugates for local and sustained chemotherapeutic delivery. Bioconjug Chem 26(7):1212–1223PubMedPubMedCentralCrossRefGoogle Scholar
  41. 41.
    Sahu P, Kashaw SK, Sau S et al (2018) pH responsive 5‑fluorouracil loaded biocompatible nanogels for topical chemotherapy of aggressive melanoma. Colloids Surf B Biointerfaces 174:232–245PubMedCrossRefGoogle Scholar
  42. 42.
    Charron P, Adler Y (2015) “Ten Commandments” of 2015 ESC Guidelines for diagnosis and management of pericardial diseases. Eur Heart J 36(42):2874PubMedGoogle Scholar
  43. 43.
    Hikosaka Y, Yano M, Otsuka S et al (2015) Post-irradiation constrictive pericarditis following thymoma treatment: a report of two cases. Gen Thorac Cardiovasc Surg 63(7):413–415PubMedCrossRefGoogle Scholar
  44. 44.
    Olopade OI, Ultmann JE (1991) Malignant effusions. CA Cancer J Clin 41(3):166–179PubMedCrossRefGoogle Scholar
  45. 45.
    Walker CM, Saldaña DA, Gladish GW et al (2013) Cardiac complications of oncologic therapy. Radiographics 33(6):1801–1815PubMedCrossRefGoogle Scholar
  46. 46.
    Memon A, Zawadzki ZA (1981) Malignant effusions: diagnostic evaluation and therapeutic strategy. Curr Probl Cancer 5(8):1–30PubMedCrossRefGoogle Scholar
  47. 47.
    Zatta KC, Frank LA, Reolon LA et al (2018) An Inhalable powder formulation based on micro- and nanoparticles containing 5‑Fluorouracil for the treatment of metastatic melanoma. Nanomaterials (Basel).  https://doi.org/10.3390/nano8020075 PubMedCentralCrossRefGoogle Scholar
  48. 48.
    Wu X, Liu J, Yang L, Wang F (2018) Photothermally controlled drug release system with high dose loading for synergistic chemo-photothermal therapy of multidrug resistance cancer. Colloids Surf B Biointerfaces 175:239–247PubMedCrossRefGoogle Scholar
  49. 49.
    Upadhyay A, Yagnik B, Desai P, Dalvi SV (2018) Microbubble-mediated enhanced delivery of curcumin to cervical cancer cells. ACS Omega 3(10):12824–12831PubMedPubMedCentralCrossRefGoogle Scholar
  50. 50.
    Mahoney KM, Rennert PD, Freeman GJ (2015) Combination cancer immunotherapy and new immunomodulatory targets. Nat Rev Drug Discov 14:561PubMedCrossRefGoogle Scholar
  51. 51.
    Sharma P, Hu-Lieskovan S, Wargo JA, Ribas A (2017) Primary, adaptive, and acquired resistance to cancer immunotherapy. Cell 168(4):707–723PubMedPubMedCentralCrossRefGoogle Scholar
  52. 52.
    Hafeez U, Gan HK, Scott AM (2018) Monoclonal antibodies as immunomodulatory therapy against cancer and autoimmune diseases. Curr Opin Pharmacol 41:114–121PubMedCrossRefGoogle Scholar
  53. 53.
    Pol J, Buqué A, Aranda F et al (2016) Trial Watch-Oncolytic viruses and cancer therapy. Oncoimmunology 5(2):e1117740PubMedCrossRefGoogle Scholar
  54. 54.
    Topalian SL, Weiner GJ, Pardoll DM (2011) Cancer immunotherapy comes of age. J Clin Oncol 29(36):4828–4836PubMedPubMedCentralCrossRefGoogle Scholar
  55. 55.
    Gowrishankar K, Birtwistle L, Micklethwaite K (2018) Manipulating the tumor microenvironment by adoptive cell transfer of CAR T‑cells. Mamm Genome 29(11-12):739–756PubMedCrossRefGoogle Scholar
  56. 56.
    Marrone KA, Ying W, Naidoo J (2016) Immune-related adverse events from immune checkpoint inhibitors. Clin Pharmacol Ther 100(3):242–251PubMedCrossRefGoogle Scholar
  57. 57.
    Chinnasamy D, Yu Z, Theoret MR et al (2010) Gene therapy using genetically modified lymphocytes targeting VEGFR-2 inhibits the growth of vascularized syngenic tumors in mice. J Clin Invest 120(11):3953–3968PubMedPubMedCentralCrossRefGoogle Scholar
  58. 58.
    Thickett DR, Armstrong L, Millar AB (1999) Vascular endothelial growth factor (VEGF) in inflammatory and malignant pleural effusions. Thorax 54(8):707–710PubMedPubMedCentralCrossRefGoogle Scholar
  59. 59.
    Berse B, Brown LF, Van de Water L et al (1992) Vascular permeability factor (vascular endothelial growth factor) gene is expressed differentially in normal tissues, macrophages, and tumors[J]. Mol Biol Cell 3(2):211–220.  https://doi.org/10.1091/mbc.3.2.211 PubMedPubMedCentralCrossRefGoogle Scholar
  60. 60.
    Vatsa R, Kumar L, Kumar S, Roy KK, Singh N, Meena J (2018) Frontline use of bevacizumab in ovarian cancer: Experience from India. Natl Med J India 31(1):15–18PubMedCrossRefGoogle Scholar
  61. 61.
    Chen D, Zhang Y, Shi F et al (2015) Sustained response of malignant pericardial effusion to intrapericardial bevacizumab in an advanced lung cancer patient: a case report and literature review. Onco Targets Ther 8:2767–2770PubMedPubMedCentralGoogle Scholar
  62. 62.
    Chen D, Zhang Y, Shi F et al (2016) Intrapericardial bevacizumab safely and effectively treats malignant pericardial effusion in advanced cancer patients. Oncotarget 7(32):52436–52441PubMedPubMedCentralGoogle Scholar
  63. 63.
    Del RM, Tsai H, Dasanu CA (2016) Prolonged survival in colon cancer with malignant pericardial effusion and pulmonary lymphangitic carcinomatosis: a case for monoclonal antibodies. Conn Med 80(8):483–485Google Scholar
  64. 64.
    Ueda T, Tsubamoto H, Eguchi A, Terada T, Shibahara H (2016) Bevacizumab helped resolve pericardial and pleural effusion that was associated with malignant ovarian clear cell carcinoma. Gynecol Oncol Rep 16:11–13PubMedPubMedCentralCrossRefGoogle Scholar
  65. 65.
    Oida T, Mimatsu K, Kano H et al (2010) Pericardiocentesis with cisplatin for malignant pericardial effusion and tamponade. World J Gastroenterol 16(6):740–744PubMedPubMedCentralCrossRefGoogle Scholar
  66. 66.
    Restifo NP, Dudley ME, Rosenberg SA (2012) Adoptive immunotherapy for cancer: harnessing the T cell response. Nat Rev Immunol 12(4):269–281PubMedPubMedCentralCrossRefGoogle Scholar
  67. 67.
    Brichard VG, Lejeune D (2007) GSK’s antigen-specific cancer immunotherapy programme: pilot results leading to Phase III clinical development. Vaccine 25(Suppl 2):B61–B71PubMedCrossRefGoogle Scholar
  68. 68.
    Engels B, Engelhard VH, Sidney J et al (2013) Relapse or eradication of cancer is predicted by peptide-major histocompatibility complex affinity. Cancer Cell 23(4):516–526PubMedPubMedCentralCrossRefGoogle Scholar
  69. 69.
    Radvanyi LG, Bernatchez C, Zhang M et al (2012) Specific lymphocyte subsets predict response to adoptive cell therapy using expanded autologous tumor-infiltrating lymphocytes in metastatic melanoma patients. Clin Cancer Res 18(24):6758–6770PubMedPubMedCentralCrossRefGoogle Scholar
  70. 70.
    Toh U, Fujii T, Seki N, Niiya F, Shirouzu K, Yamana H (2006) Characterization of IL-2-activated TILs and their use in intrapericardial immunotherapy in malignant pericardial effusion. Cancer Immunol Immunother 55(10):1219–1227PubMedCrossRefGoogle Scholar
  71. 71.
    Helms MW, Prescher JA, Cao YA, Schaffert S, Contag CH (2010) IL-12 enhances efficacy and shortens enrichment time in cytokine-induced killer cell immunotherapy. Cancer Immunol Immunother 59(9):1325–1334PubMedPubMedCentralCrossRefGoogle Scholar
  72. 72.
    Hu J, Hu J, Liu X, Hu C, Li M, Han W (2017) Effect and safety of cytokine-induced killer (CIK) cell immunotherapy in patients with breast cancer: a meta-analysis. Medicine (Baltimore) 96(42):e8310CrossRefGoogle Scholar
  73. 73.
    Zhao X, Ji CY, Liu GQ et al (2015) Immunomodulatory effect of DC/CIK combined with chemotherapy in multiple myeloma and the clinical efficacy. Int J Clin Exp Pathol 8(10):13146–13155PubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Cardiologythe Fourth Affiliated Hospital of Hebei Medical UniversityShijiazhuangChina
  2. 2.Department of Clinical Medicine, Basic Medical College of Seven Years (2014)Hebei Medical UniversityShijiazhuang, Hebei ProvinceChina

Personalised recommendations