The traditional approach to treatment of malignant pericardial effusion has been surgical, with establishment of a pericardial window. Conservative management with local instillation of chemotherapeutic agents and/or focal radiotherapy has received less attention, particularly when solid tumors have been causative. This series of 5 patients with antemortem diagnoses of malignant pericardial disease had predominant pericardial effusion rather than tumor encasement as the basis for tamponade. These 5 patients received initial therapy with local instillation of a chemotherapeutic agent ± radiotherapy. Four of the 5 made complete responses with total disappearance of cardiac symptoms and signs. Two of the responders are dead, 4 and 12 months, respectively, after initial treatment, neither showing significant pericardial fluid at postmortem examination. Two patients are alive and asymptomatic, 40 months and 8 months, respectively, after initial therapy. A literature review of treatment of malignant pericardial effusions discloses longer symptom‐free intervals in patients treated by conservative measures compared to surgical programs utilizing pericardial window accompanied by any combination of other treatment modalities.

No abstract

Five hundred and forty-two patients have been treated for prostatic carcinoma with radiotherapy between 1965 and 1976 at our institution. All patients have been followed for longer than one year. Two hundred and ninety-five patients have been subjected to surgical exploration to document the precise stage of their disease and undergone staging pelvic lymphadenectomy at the time of interstitial implantation of radioactive gold grains. Postoperatively, these patients have received an average of 4500 rad, given over one month, external beam radiotherapy to the prostate. Excellent survival data are presented including the results of post treatment needle biopsy in a selected number of patients.

No abstract