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Cardiac Radiotherapy

Nienke Hoekstra, Emmanuelle Fleury, Tomas Rodrigo Merino Lara, Peter van der Baan, Andy Bahnerth, Gerson Struik, Mischa Hoogeman, Jean-Philippe Pignol
INTRODUCTION: For early stage breast cancer patients, non-breast cancer mortality including secondary cancers and cardiac events can overshadow the benefit of adjuvant radiotherapy. This study evaluates the excess risk of secondary cancer for various breast radiotherapy techniques including accelerated partial breast irradiation (APBI). METHODS: Secondary cancers Lifetime Attributable Risks (LAR) were calculated using a modified BEIR-VII formalism to account for the specific survival of breast cancer patients...
June 15, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Eoin Donnellan, Brian P Griffin, Douglas R Johnston, Zoran B Popovic, Alaa Alashi, Samir R Kapadia, E Murat Tuzcu, Amar Krishnaswamy, Stephanie Mick, Lars G Svensson, Milind Y Desai
OBJECTIVES: The aim of this study was to study differences in progression of aortic stenosis (AS) in patients with mediastinal radiotherapy (XRT)-associated moderate AS versus a matched cohort during the same time frame, and to ascertain need for aortic valve replacement (AVR) and longer-term survival. BACKGROUND: Rate of progression of XRT-associated moderate AS and its impact on outcomes is not well-described. METHODS: We included 81 patients (age 61 ± 13 years; 57% female) with at least XRT-associated moderate AS (aortic valve area [AVA] 1...
June 8, 2018: JACC. Cardiovascular Imaging
Mohammad Taghi Bahreyni Toossi, Shokouhozaman Soleymanifard, Bagher Farhood, Shokoufeh Mohebbi, David Davenport
Aim: The objective was to quantify the accuracy of dose calculation for out-of-field regions by the commercially available TiGRT version 1.2 (LinaTech, Sunnyvale, CA, USA) treatment planning system (TPS) for a clinical treatment delivered on a Siemens Primus with the single energy of 6 MV. Materials and Methods: Two tangential open fields were planned by TiGRT TPS to irradiate the left breast of a RANDO phantom. Dose values to out-of-field points were calculated by TiGRT TPS...
April 2018: Journal of Cancer Research and Therapeutics
Yoshiko Doi, Yuji Murakami, Nobuki Imano, Yuki Takeuchi, Ippei Takahashi, Ikuno Nishibuchi, Tomoki Kimura, Yasushi Nagata
INTRODUCTION: Cardiac toxicity after definitive chemoradiotherapy for esophageal cancer is a critical issue. To reduce irradiation doses to organs at risk, individual internal margins need to be identified and minimized. The purpose of this study was to quantify esophageal motion using fiducial makers based on four-dimensional computed tomography, and to evaluate the inter-CBCT session marker displacement using breath-hold. MATERIALS AND METHODS: Sixteen patients with early stage esophageal cancer, who received endoscopy-guided metallic marker placement for treatment planning, were included; there were 35 markers in total, with 9, 15, and 11 markers in the upper thoracic, middle thoracic, and lower thoracic/esophagogastric junction regions, respectively...
2018: PloS One
Vivek Verma, J Isabelle Choi, Charles B Simone
The prognosis of limited-stage small cell lung cancer (LS-SCLC) continues to improve and is now roughly comparable to that of locally advanced non-small cell lung cancer (NSCLC). This shift, taken together with the decreased toxicities of modern radiotherapy (RT) for LS-SCLC compared with those reported in historical trials, necessitates further evaluation of whether proton beam therapy (PBT) could further reduce both acute and late toxicities for patients receiving concurrent chemoradiotherapy for LS-SCLC...
April 2018: Translational Lung Cancer Research
Christina Rodríguez Ruiz, Marcel Mesa-Pabón, Katherine Soto, José Hernández Román, Angel López-Candales
Exposure to radiotherapy has been shown to accelerate myocardial damage or injury to the cardiac vasculature. Accelerated coronary artery disease (CAD) is one of the main manifestations of cardiac disease in patients who undergo mediastinal radiation therapy. We present the cases of three young patients who developed severe CAD secondary to remote mediastinal radiotherapy.
January 2018: Heart Views: the Official Journal of the Gulf Heart Association
Qian Li, Ying Tong, Yong Yin, Pinjing Cheng, Guanzhong Gong
PURPOSE: The aim was to measure the cardiac motion-induced displacements of major coronary artery bifurcations utilizing electrocardiography (ECG)-gated four-dimensional computed tomography (4D-CT) and to determine the margin of coronary artery bifurcations. METHODS: Thirty-seven female patients who underwent retrospective ECG-gated 4D-CT in inspiratory breath hold (IBH) were enrolled. The left main coronary artery bifurcation (LM), the obtuse marginal branch bifurcation (OM), the first diagonal branch bifurcation (D1 ), the second diagonal branch bifurcation (D2 ), the caudal portion of the left anterior descending branch (APX), the first right ventricular artery bifurcation (V) and the acute marginal branch bifurcation (AM) were contoured...
May 2018: Physica Medica: PM
Chiu-Fan Chen, Min-Hsi Lin, Kuo-An Chu, Wen-Shan Liu, Shih-Hung Hsiao, Ruay-Sheng Lai
Cardiac radiotherapy is rarely used in clinical practice because of concern of adverse effects on the heart. We present a case of a 64-year-old man with advanced small cell lung cancer (SCLC) treated with chemo-radiotherapy who attained partial remission initially but had disease progression to bulky cardiac metastasis and significant pericardial effusion. Severe heart failure with hepatic failure was found. Chemotherapy and pericardiocentesis were contraindicated because of the associated high risk and bleeding tendency...
April 2018: Journal of Thoracic Disease
Leonid B Reshko, Noah S Kalman, Geoffrey D Hugo, Elisabeth Weiss
Background: The impact of radiation dose to the heart in early-stage lung cancer patients treated with definitive stereotactic body radiation therapy (SBRT) is not well known. We, therefore, analyzed whether higher radiation dose to the heart would lead to an increase in cardiac toxicity and overall mortality. Methods: Seventy-four patients with 75 tumors treated definitively with SBRT for early-stage non-small cell lung cancer (NSCLC) and two cases of limited-stage small cell lung cancer (SCLC) with an average follow-up of 35 months (range, 1-130 months) were retrospectively analyzed...
April 2018: Journal of Thoracic Disease
Ye Zeng
Cancer is one of the most serious diseases with high incidence and high mortality rate threaten human health and quality of life. The researches on mechanisms of cancer development and metastasis, and effective and reasonable treatment strategies are of great significance. The traditional treatments for tumors such as surgery, radiotherapy, and chemotherapy have some benefits, but many drawbacks such as drug-resistance and side-effects. With the emergence of new therapeutic methods such as tumor-targeted drugs and immune drugs, the survival of cancer patients is improved, but reports on cardiac damage caused by therapeutic drugs are increasing...
May 15, 2018: Cellular and Molecular Biology
Meghan W Macomber, Stephen R Bowen, Olga Gopan, Rosanna Yeung, Smith Apisarnthanarax, Jing Zeng, Shilpen Patel
Purpose Studies have shown that radiation dose to the heart may be associated with worse outcomes in patients receiving chemoradiation for lung cancer. As esophageal cancer radiation treatment can result in relatively high cardiac doses, we evaluated a single-institution database of patients treated for esophageal cancer for heart dose and outcomes. Methods We retrospectively reviewed 59 patients with stage IIA-IIIB esophageal cancer treated with neoadjuvant chemoradiation to 50.4 Gy followed by esophagectomy from 2007-2015...
March 27, 2018: Curēus
S Sabater, A Montero, T López Fernández, J J González Ferrer, M Arenas
BACKGROUND: There is an increasing number of patients with cardiac implantable electronic devices (CIED), either pacemakers or defibrillators, who are receiving a course of radiotherapy. Several guidelines have been published by national societies, but no Spanish national guidelines for management of these patients have been published. More importantly, national clinical practice regarding these patients is not standardised. MATERIALS AND METHODS: Members of the Spanish Breast Cancer Radiation Oncology Group (GEORM in Spanish) were surveyed through an online questionnaire on behalf of the Spanish radiation oncology departments...
May 23, 2018: Clinical & Translational Oncology
Carolyn Taylor, Paul McGale, Dorthe Brønnum, Candace Correa, David Cutter, Frances K Duane, Bruna Gigante, Maj-Britt Jensen, Ebbe Lorenzen, Kazem Rahimi, Zhe Wang, Sarah C Darby, Per Hall, Marianne Ewertz
Purpose Incidental cardiac irradiation can cause cardiac injury, but little is known about the effect of radiation on specific cardiac segments. Methods For 456 women who received breast cancer radiotherapy between 1958 and 2001 and then later experienced a major coronary event, information was obtained on the radiotherapy regimen they received and on the location of their cardiac injury. For 414 women, all with documented location of left ventricular (LV) injury, doses to five LV segments were estimated. For 133 women, all with documented location of coronary artery disease with ≥ 70% stenosis, doses to six coronary artery segments were estimated...
May 23, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
A Kim, A M Kalet, N Cao, D S Hippe, L C Fang, L Young, J Meyer, E V Lang, N A Mayr
AIMS: Deep inspiration breath hold (DIBH) reduces cardiac radiation exposure by creating cardiac-chest wall separation in breast cancer radiotherapy. DIBH requires sustaining chest wall expansion for up to 40 s and involves complex co-ordination of thoraco-abdominal muscles, which may not be intuitive to patients. We investigated the effect of in-advance preparatory DIBH coaching and home practice on cardiac doses. MATERIALS AND METHODS: Successive patients from 1 February 2015 to 31 December 2016 with left-sided breast cancer who underwent tangential field radiotherapy utilising the DIBH technique were included...
May 14, 2018: Clinical Oncology: a Journal of the Royal College of Radiologists
Habib R Khan, Mohammad I Ansari, Andrew P Thain, Sadia Abdullah, Ramya Parasa, Richard W Varcoe
A 46-year-old man presented with mass on chest x-ray along with a 6-month history of weight loss, dyspnea and cough. He was hypotensive and an echocardiogram showed large extra-cardiac mass compressing the right ventricular outflow tract resulting in features of cardiac tamponade. Chest computed tomography revealed a mediastinal mass invading the pericardium adjacent to right ventricular outflow tract. Biopsy of the mass confirmed primary monophasic synovial sarcoma. Chemotherapy and radiotherapy along with anti-inflammatories were given as surgery was too high risk due to the location of the tumour and pericardial involvement...
May 2018: Oxford Medical Case Reports
Jason R Cuomo, Sean P Javaheri, Gyanendra K Sharma, Deepak Kapoor, Adam E Berman, Neal L Weintraub
Radiation-induced coronary heart disease (RICHD) is the second most common cause of morbidity and mortality in patients treated with radiotherapy for breast cancer, Hodgkin's lymphoma and other prevalent mediastinal malignancies. The risk of RICHD increases with radiation dose. Exposed patients may present decades after treatment with manifestations ranging from asymptomatic myocardial perfusion defects to ostial, triple-vessel disease and sudden cardiac death. RICHD is insidious, with a long latency and a tendency to remain silent late into the disease course...
May 15, 2018: Heart: Official Journal of the British Cardiac Society
Raphaël Jumeau, Mahmut Ozsahin, Juerg Schwitter, Véronique Vallet, Frédéric Duclos, Michele Zeverino, Raphaël Moeckli, Etienne Pruvot, Jean Bourhis
Stereotactic body radiotherapy (SBRT) is an emerging non-invasive treatment in the management of ventricular tachycardia (VT). We report here an intensive care patient suffering from an electrical storm due to incessant VT, unresponsive to catheter ablation and anti-arrhythmic drugs, showing an immediate and durable response to electrophysiology-guided cardiac SBRT.
May 9, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Rui Zhang, David Heins, Mary Sanders, Beibei Guo, Kenneth Hogstrom
PURPOSE: The purpose of this study was to assess the potential benefits and limitations of a mixed beam therapy, which combined bolus electron conformal therapy (BECT) with intensity modulated photon radiotherapy (IMRT) and volumetric modulated photon arc therapy (VMAT), for left-sided post-mastectomy breast cancer patients. METHODS: Mixed beam treatment plans were produced for nine post-mastectomy radiotherapy (PMRT) patients previously treated at our clinic with VMAT alone...
May 10, 2018: Medical Physics
Domenico Plantone, Tatiana Koudriavtseva
The process of finding new therapeutic indications for currently used drugs, defined as 'repurposing', is receiving growing attention. Chloroquine and hydroxychloroquine, with an original indication to prevent or cure malaria, have been successfully used to treat several infectious (HIV, Q fever, Whipple's disease, fungal infections), rheumatological (systemic lupus erythematosus, antiphospholipid antibody syndrome, rheumatoid arthritis, Sjögren's syndrome), and other immunological diseases. Indeed, they have anti-inflammatory, immunomodulating, anti-infective, antithrombotic, and metabolic effects...
May 8, 2018: Clinical Drug Investigation
Ahmed F Soliman, Lobna M Anees, Doaa M Ibrahim
Despite their clinical benefits in cancer treatment, the deleterious effects on heart following chemo/radiotherapy are of increasing importance. Zingerone, a natural polyphenol, possesses multiple biological activities, such as antioxidant and anti-inflammatory. Thus, the current study was designed to assess the potential cardioprotective effects of zingerone against cisplatin or γ-radiation. Zingerone was given by intragastric intubation (25 mg/kg) daily for three successive weeks prior to the induction of cardiotoxicity using a single dose of cisplatin (20 mg/kg, i...
May 7, 2018: Naunyn-Schmiedeberg's Archives of Pharmacology
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