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Management of neoplastic pericardial disease

Behandlung neoplastisch bedingter Erkrankungen des Perikards

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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.

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.

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Authors and Affiliations

  1. Department of Cardiology, the Fourth Affiliated Hospital of Hebei Medical University, 050011, Shijiazhuang, Hebei Province, China

    J. Zhang & N. Zhang

  2. Department of Clinical Medicine, Basic Medical College of Seven Years (2014), Hebei Medical University, 050017, Shijiazhuang, Hebei Province, China

    Q. Zhang & X. Chen

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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.

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Zhang, J., Zhang, Q., Chen, X. et al. Management of neoplastic pericardial disease. Herz 45 (Suppl 1), 46–51 (2020). https://doi.org/10.1007/s00059-019-4833-4

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