Cardiac perfusion changes in patients treated for breast cancer with radiation therapy and doxorubicin: Preliminary results

被引:163
作者
Hardenbergh, PH
Munley, MT
Bentel, GC
Kedem, R
Borges-Neto, S
Hollis, D
Prosnitz, LR
Marks, LB
机构
[1] Duke Univ, Med Ctr, Dept Radiat Oncol, Durham, NC 27710 USA
[2] Duke Univ, Med Ctr, Dept Nucl Med, Durham, NC 27710 USA
[3] Duke Univ, Med Ctr, Dept Biostat, Durham, NC 27710 USA
来源
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS | 2001年 / 49卷 / 04期
关键词
radiation therapy; chemotherapy; doxorubicin; cardiac toxicity; breast cancer;
D O I
10.1016/S0360-3016(00)01531-5
中图分类号
R73 [肿瘤学];
学科分类号
100214 [肿瘤学];
摘要
Purpose: To determine the incidence and dose dependence of regional cardiac perfusion abnormalities in patients with left-sided breast cancer treated with radiation therapy (RT) with and without doxorubirin (Dox), Methods: Twenty patients with left-sided breast cancer underwent cardiac perfusion imaging using single photon emission computed tomography (SPECT) prechemotherapy, pre-RT, and 6 months post-RT. SPECT perfusion images were registered onto 3-dimensional (3D) RT dose distributions. The volume of heart in the RT field was quantified, and the regional RT dose was calculated. A decrease in regional cardiac perfusion was assessed subjectively by visual inspection and objectively using image fusion software. Ten patients received Dox-based chemotherapy (total dose 120-300 mg/m(2)), and 10 patients had no chemotherapy. RT was delivered by tangent beams in all patients to a total dose of 46-50 Gy, Results: Overall, 60% of the patients had new visible perfusion defects 6 months post-RT, A dose-dependent perfusion defect was seen at 6 months with minimal defect appreciated at 0-10 Gy, acid a 20% decrease in regional perfusion at 41-50 GS. One of 20 patients had a decrease in left ventricle ejection fraction (LVEF) of greater than 10% at 6 months; 2/20 patients had developed transient pericarditis, No instances of myocardial infarction or congestive heart failure (CHF) have occurred. Conclusions: RT causes cardiac perfusion defects 6 months post-RT in most patients, Long-term follow-up is needed to assess whether these perfusion changes are transient or permanent and to determine if these findings are associated with changes in overall cardiac function and clinical outcome. (C) 2001 Elsevier Science Inc.
引用
收藏
页码:1023 / 1028
页数:6
相关论文
共 27 条
[1]
ADRIAMYCIN CARDIOTOXICITY - ENDOMYOCARDIAL BIOPSY EVIDENCE OF ENHANCEMENT BY IRRADIATION [J].
BILLINGHAM, ME ;
BRISTOW, MR ;
GLATSTEIN, E ;
MASON, JW ;
MASEK, MA ;
DANIELS, JR .
AMERICAN JOURNAL OF SURGICAL PATHOLOGY, 1977, 1 (01) :17-23
[2]
COMBINED EXERCISE RADIONUCLIDE ANGIOCARDIOGRAPHY AND SINGLE PHOTON-EMISSION COMPUTED-TOMOGRAPHY PERFUSION STUDIES FOR ASSESSMENT OF CORONARY-ARTERY DISEASE [J].
BORGESNETO, S ;
COLEMAN, RE ;
POTTS, JM ;
JONES, RH .
SEMINARS IN NUCLEAR MEDICINE, 1991, 21 (03) :223-229
[3]
RETROSPECTIVE RECONSTRUCTION OF 3-DIMENSIONAL RADIOTHERAPY TREATMENT PLANS OF THE THORAX FROM 2-DIMENSIONAL PLANNING DATA [J].
BOXWALA, AA ;
ROSENMAN, JG .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 1994, 28 (04) :1009-1015
[4]
Radiation therapy and 5-fluorouracil in pancreatic cancer [J].
Chakravarthy, A ;
Abrams, RA .
SEMINARS IN RADIATION ONCOLOGY, 1997, 7 (04) :291-299
[5]
CAUSE-SPECIFIC MORTALITY IN LONG-TERM SURVIVORS OF BREAST-CANCER WHO PARTICIPATED IN TRIALS OF RADIOTHERAPY [J].
CUZICK, J ;
STEWART, H ;
RUTQVIST, L ;
HOUGHTON, J ;
EDWARDS, R ;
REDMOND, C ;
PETO, R ;
BAUM, M ;
FISHER, B ;
HOST, H ;
LYTHGOE, J ;
RIBEIRO, G ;
SCHEURLEN, H .
JOURNAL OF CLINICAL ONCOLOGY, 1994, 12 (03) :447-453
[6]
Cardiotoxicity from intensive chemotherapy combined with radiotherapy in breast cancer [J].
deGraaf, H ;
Dolsma, WV ;
Willemse, PHB ;
vanderGraaf, WTA ;
Sleijfer, DT ;
deVries, EGE ;
Mulder, NH .
BRITISH JOURNAL OF CANCER, 1997, 76 (07) :943-945
[7]
ELTRINGHAM JR, 1979, FRONT RAD THER ONCOL, V13, P21
[8]
Ewer MS, 1999, SEMIN ONCOL, V26, P96
[9]
FREEMAN NJ, 1988, CANCER-AM CANCER SOC, V61, P36, DOI 10.1002/1097-0142(19880101)61:1<36::AID-CNCR2820610108>3.0.CO
[10]
2-6