Management of malignant pericardial effusion with instillation of mitomycin C in non-small cell lung cancer

Background: To evaluate the clinical efficacy and safety of mitomycin C in the local control of malignant pericardial effusion, we carried out a trial of pericardial drainage with local instillation of mitomycin C in eight patients who suffered from cardiac tamponade or symptomatic large pericardial effusion caused by advanced non-small cell lung cancer. Methods: After complete removal of the pericardial effusion by an ultrasound-guided inserted catheter, 2 mg of mitomycin C was instilled into the pericardial space via the catheter. Results: The drainage catheter was successfully removed in all patients. The duration of pericardial drainage ranged from 7 to 14 days (median 10.5 days). Six of the eight patients achieved a complete remission of pericardial effusions without any adverse effects. Conclusion: Intrapericardial instillation of 2 mg of mitomycin C was feasible and demonstrated a promising response against malignant pericardial effusion resulting from non-small cell lung cancer.