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Cardiac Radiotherapy

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https://www.readbyqxmd.com/read/28215665/11-years-follow-up-of-trastuzumab-after-adjuvant-chemotherapy-in-her2-positive-early-breast-cancer-final-analysis-of-the-herceptin-adjuvant-hera-trial
#1
David Cameron, Martine J Piccart-Gebhart, Richard D Gelber, Marion Procter, Aron Goldhirsch, Evandro de Azambuja, Gilberto Castro, Michael Untch, Ian Smith, Luca Gianni, Jose Baselga, Nedal Al-Sakaff, Sabine Lauer, Eleanor McFadden, Brian Leyland-Jones, Richard Bell, Mitch Dowsett, Christian Jackisch
BACKGROUND: Clinical trials have shown that trastuzumab, a recombinant monoclonal antibody against HER2 receptor, significantly improves overall survival and disease-free survival in women with HER2-positive early breast cancer, but long-term follow-up data are needed. We report the results of comparing observation with two durations of trastuzumab treatment at a median follow-up of 11 years, for patients enrolled in the HERA (HERceptin Adjuvant) trial. METHODS: HERA (BIG 1-01) is an international, multicentre, open-label, phase 3 randomised trial of 5102 women with HER2-positive early breast cancer, who were enrolled from hospitals in 39 countries between Dec 7, 2001, and June 20, 2005...
February 16, 2017: Lancet
https://www.readbyqxmd.com/read/28203163/is-the-deep-inspiration-breath-hold-technique-superior-to-the-free-breathing-technique-in-cardiac-and-lung-sparing-while-treating-both-left-sided-post-mastectomy-chest-wall-and-supraclavicular-regions
#2
Anupama Darapu, Rajesh Balakrishnan, Patricia Sebastian, Mohamathu Rafic Kather Hussain, Paul Ravindran, Subhashini John
AIMS: To evaluate the efficacy of the deep inspirational breath-hold (DIBH) technique and its dosimetric advantages over the free breathing (FB) technique in cardiac (heart and left anterior descending artery [LAD]) and ipsilateral lung sparing in left-sided post-mastectomy field-in-field conformal radiotherapy. DIBH is highly reproducible, and this study aims to find out its dosimetric benefits over FB. MATERIALS AND METHODS: Nineteen left-sided mastectomy patients were immobilized using breast boards with both arms positioned above the head...
January 2017: Case Reports in Oncology
https://www.readbyqxmd.com/read/28188697/a-case-study-evaluating-deep-inspiration-breath-hold-and-intensity-modulated-radiotherapy-to-minimise-long-term-toxicity-in-a-young-patient-with-bulky-mediastinal-hodgkin-lymphoma
#3
Jonathan M Tomaszewski, Sarah Crook, Kenneth Wan, Lucille Scott, Farshad Foroudi
Radiotherapy plays an important role in the treatment of early-stage Hodgkin lymphoma, but late toxicities such as cardiovascular disease and second malignancy are a major concern. Our aim was to evaluate the potential of deep inspiration breath-hold (DIBH) and intensity-modulated radiotherapy (IMRT) to reduce cardiac dose from mediastinal radiotherapy. A 24 year-old male with early-stage bulky mediastinal Hodgkin lymphoma received involved-site radiotherapy as part of a combined modality programme. Simulation was performed in free breathing (FB) and DIBH...
February 11, 2017: Journal of Medical Radiation Sciences
https://www.readbyqxmd.com/read/28188473/outpatient-treatment-with-the-wearable-cardioverter-defibrillator-clinical-experience-in-two-dutch-centres
#4
A F B E Quast, V F van Dijk, A A M Wilde, R E Knops, L V A Boersma
INTRODUCTION: The latest European Society of Cardiology Guidelines recommend consideration of a wearable cardioverter-defibrillator (WCD) for patients with a poor left ventricular ejection fraction (LVEF) who are at risk of sudden arrhythmic death but are not eligible for an implantable defibrillator. For these patients a WCD can be an alternative to long-term hospitalisation. PURPOSE: To evaluate the use of WCD therapy in these patient groups in two Dutch centres...
February 10, 2017: Netherlands Heart Journal
https://www.readbyqxmd.com/read/28151876/late-onset-radiation-induced-constrictive-pericarditis-and-cardiomyopathy-after-radiotherapy-a-case-report
#5
Xiao-Feng Zhuang, Yan-Min Yang, Xiao-Lu Sun, Zhong-Kai Liao, Jie Huang
INTRODUCTION: Radiation-induced heart disease (RIHD) is a serious side effect of cancer treatment, including coronary artery disease, valvular cardiac dysfunction, cardiomyopathy, aortopathy, and chronic constrictive pericarditis. Herein, this case we present was diagnosed as radiation-induced constrictive pericarditis and cardiomyopathy by means of cardiac magnetic resonance (CMR) and transthoracic echocardiogram, finally confirmed by pathology after performing heart transplant operation...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28143884/risk-of-heart-failure-in-survivors-of-hodgkin-lymphoma-effects-of-cardiac-exposure-to-radiation-and-anthracyclines
#6
Frederika A van Nimwegen, Georgios Ntentas, Sarah C Darby, Michael Schaapveld, Michael Hauptmann, Pieternella J Lugtenburg, Cecile P M Janus, Laurien Daniels, Flora E van Leeuwen, David J Cutter, Berthe M P Aleman
Hodgkin lymphoma (HL) survivors treated with radiotherapy and/or chemotherapy are known to have increased risks of heart failure (HF), but a radiation dose-response relationship has not previously been derived. A case-control study, nested in a cohort of 2,617 five-year survivors of HL diagnosed before age 51 years during 1965-1995, was conducted. Cases (n=91) had moderate or severe HF as their first cardiovascular diagnosis. Controls (n=278) were matched to cases on age, gender and HL diagnosis date. Treatment and follow-up information were abstracted from medical records...
January 31, 2017: Blood
https://www.readbyqxmd.com/read/28139381/assessment-of-upfront-selection-criteria-to-prioritise-patients-for-breath-hold-left-sided-breast-radiotherapy
#7
N Tanna, R McLauchlan, S Karis, C Welgemoed, D M Gujral, S J Cleator
AIMS: Deep inspiratory breath-hold (DIBH) techniques for left breast and chest wall radiotherapy can reduce cardiac dose. We investigated the use of 'upfront selection' criteria for DIBH based on tumour bed position and whether cardiac shielding was used. MATERIALS AND METHODS: Four methods of selecting patients for DIBH were assessed retrospectively in a cohort of left breast and chest wall treatments. These were: (1) free breathing scan on all patients, selecting DIBH treatment for those with a predicted mean heart dose ≥3 Gy; (2) selective DIBH for those with maximum heart depth (MHD) on free breathing scan ≥1 cm; (3) use of an 'upfront selection process' using tumour bed position as initial selection and measurement of MHD on those not selected upfront; (4) DIBH on all...
January 27, 2017: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/28132957/risk-of-heart-failure-with-preserved-ejection-fraction-in-older-women-after-contemporary-radiotherapy-for-breast-cancer
#8
Hirofumi Saiki, Ivy A Petersen, Christopher G Scott, Kent R Bailey, Shannon M Dunlay, Randi R Finley, Kathryn J Ruddy, Elizabeth Yan, Margaret M Redfield
BACKGROUND: -Cardiomyocytes are resistant to radiation. However, cardiac radiation exposure causes coronary microvascular endothelial inflammation, a perturbation implicated in the pathogenesis of heart failure (HF) and particularly, HF with preserved ejection fraction (HFpEF). Radiotherapy for breast cancer results in variable cardiac radiation exposure and may increase the risk of HF. METHODS: -We conducted a population-based case-control study of incident HF in 170 female residents of Olmsted County, Minnesota (59 cases and 111 controls) who underwent contemporary (1998-2013) radiotherapy for breast cancer utilizing computed tomography-assisted radiotherapy planning...
January 29, 2017: Circulation
https://www.readbyqxmd.com/read/28117246/radiotherapy-induced-right-ventricular-remodelling-the-missing-piece-of-the-puzzle
#9
REVIEW
Marijana Tadic, Cesare Cuspidi, Dagmara Hering, Lucia Venneri, Isidora Grozdic-Milojevic
The number of studies demonstrating that right ventricular structure, function and mechanics are valuable predictors of cardiovascular and total morbidity and mortality in patients with a wide range of cardiovascular conditions is constantly increasing. Most studies that evaluated the influence of radiotherapy on the heart focused on left ventricular remodelling, which is why current guidelines only recommend detailed assessment of the left ventricle. Data regarding right ventricular changes in cancer patients treated with radiotherapy are scarce...
January 20, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28113017/cardiac-toxicity-after-radiotherapy-for-stage-iii-non-small-cell-lung-cancer-pooled-analysis-of-dose-escalation-trials-delivering-70-to-90-gy
#10
Kyle Wang, Michael J Eblan, Allison M Deal, Matthew Lipner, Timothy M Zagar, Yue Wang, Panayiotis Mavroidis, Carrie B Lee, Brian C Jensen, Julian G Rosenman, Mark A Socinski, Thomas E Stinchcombe, Lawrence B Marks
Purpose The significance of radiotherapy (RT) -associated cardiac injury for stage III non-small-cell lung cancer (NSCLC) is unclear, but higher heart doses were associated with worse overall survival in the Radiation Therapy Oncology Group (RTOG) 0617 study. We assessed the impact of heart dose in patients treated at our institution on several prospective dose-escalation trials. Patients and Methods From 1996 to 2009, 127 patients with stage III NSCLC (Eastern Cooperative Oncology Group performance status, 0 to 1) received dose-escalated RT to 70 to 90 Gy (median, 74 Gy) in six trials...
January 23, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28095159/validation-and-modification-of-a-prediction-model-for-acute-cardiac-events-in-patients-with-breast-cancer-treated-with-radiotherapy-based-on-three-dimensional-dose-distributions-to-cardiac-substructures
#11
Veerle A B van den Bogaard, Bastiaan D P Ta, Arjen van der Schaaf, Angelique B Bouma, Astrid M H Middag, Enja J Bantema-Joppe, Lisanne V van Dijk, Femke B J van Dijk-Peters, Laurens A W Marteijn, Gertruida H de Bock, Johannes G M Burgerhof, Jourik A Gietema, Johannes A Langendijk, John H Maduro, Anne P G Crijns
Purpose A relationship between mean heart dose (MHD) and acute coronary event (ACE) rate was reported in a study of patients with breast cancer (BC). The main objective of our cohort study was to validate this relationship and investigate if other dose-distribution parameters are better predictors for ACEs than MHD. Patients and Methods The cohort consisted of 910 consecutive female patients with BC treated with radiotherapy (RT) after breast-conserving surgery. The primary end point was cumulative incidence of ACEs within 9 years of follow-up...
January 17, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28089158/cardiac-dose-and-survival-after-stereotactic-body-radiotherapy-for-early-stage-non-small-cell-lung-cancer
#12
Amode R Tembhekar, Cari L Wright, Megan E Daly
INTRODUCTION: Recent analyses have identified cardiac dose as an important predictor of overall survival (OS) after chemoradiation for locally advanced non-small-cell lung cancer (NSCLC). However, the survival influence of the cardiac dose after stereotactic body radiotherapy (SBRT) is unknown. We performed a dose-volume histogram (DVH) analysis of patients treated with SBRT for early stage NSCLC to examine survival and cardiac toxicity. MATERIALS AND METHODS: We reviewed the medical records of patients who had undergone SBRT for early-stage NSCLC from June 2007 to June 2015 and documented the cardiac DVH parameters, including the maximum and mean dose and percentage of volume receiving >5, >10, >20, and >30 Gy (V5, V10, V20, and V30, respectively)...
December 22, 2016: Clinical Lung Cancer
https://www.readbyqxmd.com/read/28075422/inflammation-cardiometabolic-markers-and-functional-changes-in-men-with-prostate-cancer-a-randomized-controlled-trial-of-a-12%C3%A2-month-exercise-program
#13
Katarzyna Hojan, Eliza Kwiatkowska-Borowczyk, Ewa Leporowska, Piotr Milecki
INTRODUCTION Previous studies have shown that physical exercise in cancer patients during radiation therapy (RT) and androgen deprivation therapy (ADT) improves cardiac fitness and quality of life (QoL), as well as reduces fatigue, but it is still not entirely known how it affects inflammation or metabolic factors and what its consequences are in patients with prostate cancer (PCa). OBJECTIVES The aim of the study was to assess the effect of a 12‑month physical exercise program on inflammatory and cardiometabolic parameters, as well as on functional status in patients with PCa undergoing RT and ADT...
January 10, 2017: Polskie Archiwum Medycyny Wewnętrznej
https://www.readbyqxmd.com/read/28048561/su-f-t-452-influence-of-dose-calculation-algorithm-and-heterogeneity-correction-on-risk-categorization-of-patients-with-cardiac-implanted-electronic-devices-undergoing-radiotherapy
#14
P Iwai, L Nadler Lins
PURPOSE: There is a lack of studies with significant cohort data about patients using pacemaker (PM), implanted cardioverter defibrillator (ICD) or cardiac resynchronization therapy (CRT) device undergoing radiotherapy. There is no literature comparing the cumulative doses delivered to those cardiac implanted electronic devices (CIED) calculated by different algorithms neither studies comparing doses with heterogeneity correction or not. The aim of this study was to evaluate the influence of the algorithms Pencil Beam Convolution (PBC), Analytical Anisotropic Algorithm (AAA) and Acuros XB (AXB) as well as heterogeneity correction on risk categorization of patients...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048129/su-f-i-15-evaluation-of-a-new-mr-compatible-respiratory-motion-device-at-3t
#15
A Soliman, B Chugh, B Keller, A Sahgal, W Song
PURPOSE: Recent advances in MRI-guided radiotherapy has inspired the development of MRI-compatible motion devices that simulate patient periodic motion in the scanner, particularly respiratory motion. Most commercial devices rely on non MR-safe ferromagnetic stepper motors which are not practical for regular QA testing. This work evaluates the motion performance of a new fully MRI compatible respiratory motion device at 3T. METHODS: The QUASAR™ MRI-compatible respiratory motion phantom has been recently developed by Modus QA Inc...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047965/tu-h-campus-jep2-05-can-automatic-delineation-of-cardiac-substructures-on-noncontrast-ct-be-used-for-cardiac-toxicity-analysis
#16
Y Luo, Z Liao, W Jiang, D Gomez, R Williamson, L Court, J Yang
PURPOSE: To evaluate the feasibility of using an automatic segmentation tool to delineate cardiac substructures from computed tomography (CT) images for cardiac toxicity analysis for non-small cell lung cancer (NSCLC) patients after radiotherapy. METHODS: A multi-atlas segmentation tool developed in-house was used to delineate eleven cardiac substructures including the whole heart, four heart chambers, and six greater vessels automatically from the averaged 4DCT planning images for 49 NSCLC patients...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047209/su-c-brc-01-a-monte-carlo-study-of-out-of-field-doses-from-cobalt-60-teletherapy-units-intended-for-historical-correlations-of-dose-to-normal-tissue
#17
H Petroccia, E Olguin, W Culberson, B Bednarz, N Mendenhall, W Bolch
PURPOSE: Innovations in radiotherapy treatments, such as dynamic IMRT, VMAT, and SBRT/SRS, result in larger proportions of low-dose regions where normal tissues are exposed to low doses levels. Low doses of radiation have been linked to secondary cancers and cardiac toxicities. The AAPM TG Committee No.158 entitled, 'Measurements and Calculations of Doses outside the Treatment Volume from External-Beam Radiation Therapy', has been formed to review the dosimetry of non-target and out-of-field exposures using experimental and computational approaches...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046380/we-fg-202-06-the-use-of-hybrid-pet-mri-for-identifying-the-presence-of-cardiac-inflammation-following-external-beam-irradiation
#18
O El-Sherif, I Xhaferllari, J Sykes, J Butler, J Battista, G Wisenberg, F Prato, S Gaede
PURPOSE: To monitor the evolution of radiation-induced cardiac inflammation in a canine model using hybrid positron emission tomography (PET/magnetic resonance imaging (MRI). METHODS: Research ethics approval was obtained for a longitudinal imaging study of 5 canines after cardiac irradiation. Animals were imaged at baseline, 3 months, 6 months, and 12 months post cardiac irradiation using a hybrid PET-MRI system (Biograph mMR, Siemens Healthcare). The imaging protocol was designed to assess changes in cardiac inflammation using (18) F-fluorodeoxyglucose ((18) F-FDG) PET tracer...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046281/th-cd-207a-03-a-surface-deformation-driven-respiratory-model-for-organ-motion-tracking-in-lung-cancer-radiotherapy
#19
H Chen, X Zhen, L Zhou, X Gu
PURPOSE: To propose and validate a novel real-time surface-mesh-based internal organ-external surface motion and deformation tracking method for lung cancer radiotherapy. METHODS: Deformation vector fields (DVFs) which characterizes the internal and external motion are obtained by registering the internal organ and tumor contours and external surface meshes to a reference phase in the 4D CT images using a recent developed local topology preserved non-rigid point matching algorithm (TOP)...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046228/su-f-j-138-an-extension-of-pca-based-respiratory-deformation-modeling-via-multi-linear-decomposition
#20
A S Iliopoulos, N Pitsianis, X Sun, F F Yin, L Ren
PURPOSE: To address and lift the limited degree of freedom (DoF) of globally bilinear motion components such as those based on principal components analysis (PCA), for encoding and modeling volumetric deformation motion. METHODS: We provide a systematic approach to obtaining a multi-linear decomposition (MLD) and associated motion model from deformation vector field (DVF) data. We had previously introduced MLD for capturing multi-way relationships between DVF variables, without being restricted by the bilinear component format of PCA-based models...
June 2016: Medical Physics
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