Treatment of Malignant Pleural or Pericardial Effusion and Ascites Using Hyperthermia Combined with Chemotherapy

Objective:To evaluate the efficacy and tolerance of hyperthermia combined with chemotherapy in treatment of malignant pleural or pericardial effusion and as cites.Methods:All 86 cases were recurrent or metastatic cancer patients.49 cases had malignant pleural effusion,3 cases had malignant pericardial effusion and 40 cases had ascites.After drainage,one or two chemotherapeutic drugs such as DDP 50～100 mg,MMC 8～10 mg,5-Fu 1.0～1.5 g or THP-ADM 40 mg were injected into the pleural,pericardial or peritoneal cavity.By the time the patients' symptoms such as dysponea or abdominal distention relief,system chemotherapy began.Each time chemotherapy was followed by hyperthermia which maintained the cavity's temperature at 42 ℃ for 40～60 minutes.Hyperthermia was performed twice per week for 3～4 weeks(6 times at means).Then,the efficacy,quality of life and toxicities were evaluated.Results:The response rate was 87% in 49 cases with malignant pleural effusion and 76% in 50 cases with ascites and 100% in 3 cases with malignant pericardial effusion.The response rate was better in breast,lung,ovarian and digestive tract cancer patients with malignant pleural effusion or ascites.After combined treatment,the Karnofsky scores rised from 0% to 28% at 80～100 group and from 23% to 43% at 60～70 group,but there was no difference at 0～30 group.The main side effects of hyperthermia were local skin pain(17%) and fat necrosis(11%).Conclusion:Hyperthermia combined with chemotherapy is effective in the treatment of malignant pleural or pericardial effusion and ascites,and this treatment can improve the quality of life.The side effects are tolerable.