Lestuzzi Chiara, Berretta Massimiliano, Tomkowski Witold
Cardiology Unit, Oncology Department, CRO, National Cancer Institute, Via Gallini 2. 33081 Aviano (PN), Italy.
Expert Rev Cardiovasc Ther. 2015 Apr;13(4):377-89. doi: 10.1586/14779072.2015.1025754.
The best approach in diagnosis and treatment of neoplastic pericardial disease has not been defined yet. The authors report the most recent literature about the new diagnostic techniques that are useful to improve the diagnosis. The literature about the therapeutic options is critically reviewed, in order to give suggestions of use to the clinical practice. Pericardial effusion may require urgent drainage; the solid component, however, becomes predominant in some cases. Neoplastic pericardial disease should be assessed following oncologic criteria evaluation of the neoplastic burden; outcome classified as complete or partial response, stable or progressive disease and - in cases with progression - event-free survival. Systemic chemotherapy may be effective in lymphomas and possibly in breast carcinomas. Intrapericardial chemotherapy with systemic chemotherapy is the treatment of choice in lung cancer. Pericardial window with systemic chemotherapy is also effective in preventing the accumulation of large amount of fluid.
肿瘤性心包疾病的最佳诊断和治疗方法尚未明确。作者报告了有关有助于改善诊断的新诊断技术的最新文献。对有关治疗选择的文献进行了批判性综述，以便为临床实践提供使用建议。心包积液可能需要紧急引流；然而，在某些情况下，实性成分会占主导地位。肿瘤性心包疾病应根据肿瘤负荷的肿瘤学标准评估进行评估；结果分为完全或部分缓解、疾病稳定或进展，以及在疾病进展的情况下无进展生存期。全身化疗可能对淋巴瘤有效，对乳腺癌可能也有效。心包内化疗联合全身化疗是肺癌的首选治疗方法。心包开窗术联合全身化疗在预防大量液体积聚方面也有效。
