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Radiotherapy and heart

Michele Malagù, Alessandra Ferri, Ottavia Mancuso, Filippo Trevisan, Marianna Nardozza, Matteo Bertini
Implantable cardioverter defibrillator (ICD) is the cornerstone of primary and secondary prevention of sudden cardiac death. In 35 years of technologic improvement and clinical trials, there has been a continuous increase in implantation rate. Purpose of this review is to point out and discuss every aspect related to actual ICD management, investigating implantation procedure and predischarge care, office and remote monitoring follow-up, diagnostic evaluations, management of patients with suspected therapies or malfunctions, heart failure, surgery, radiotherapy and endoscopic procedures...
October 20, 2016: Future Cardiology
Afshin Fathi, Firuz Amani, Mohammad Davoodi, Sara Bahadoram, Mohammad Bahadoram
INTRODUCTION: Nasopharyngeal carcinoma among the children has been rare accounting for only 1% of all pediatric malignancies. Both genetic and environmental factors have contributed to the development of nasopharyngeal carcinoma. Among the children there was a higher rate of undifferentiated histology. The mean age of nasopharyngeal carcinoma diagnosis has been 11 years old age; and the most common site was nasopharynx. Palpable lymphadenopathy, dysphasia and neural defect were common associated signs...
August 2016: Iranian Journal of Cancer Prevention
Hyunjung Kim, Jinyoung Kim
Prone position radiotherapy for a small (< 750 cm3) breast is controversial because of the variable benefits for the irradiated heart volume. The objective anatomical parameters related with chest wall shape that can determine the heart dose sparing patients in the prone position.Twenty-one patients underwent CT-simulation in supine and prone position. Dose volume parameters were compared and the objective indexes such as the Haller index, anthropometric index, mid-sternum thickness, and central lung distance (CLD) were evaluated the relationship between the shape of the chest wall and irradiated normal tissue volume in prone position...
October 14, 2016: Oncotarget
Sara Barbiero, Alexandra Rink, Fabrizio Matteucci, David Fedele, Fabiola Paiar, Francesco Pasqualetti, Michele Avanzo
PURPOSE: To report on single-fraction stereotactic body radiotherapy (RT) (SBRT) with flattening filter (FF)-free (FFF) volumetric modulated arc therapy (VMAT) for lung cancer and to compare dosimetric results with VMAT with FF. METHODS AND MATERIALS: Overall, 25 patients were treated with 6-MV FFF VMAT (Varian TrueBeam STx LINAC) to a prescribed dose of 24Gy in a single fraction. Treatment plans were recreated using FF VMAT. Dose-volume indices, monitor units (MU), and treatment times were compared between FFF and FF VMAT techniques...
October 14, 2016: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
Jenna Dean, Carmen J Hansen, Justin Westhuyzen, Brett Waller, Kirsty Turnbull, Maree Wood, Andrew Last
INTRODUCTION: Inverse-planned intensity modulated radiation therapy (IP-IMRT) has potential benefits over other techniques for tangential intact breast radiotherapy. Possible benefits include increased homogeneity, faster planning time, less inter-planner variability and lower doses to organs at risk (OAR). We therefore conducted a pilot study of previously treated intact breast patients to compare the current forward-planned 'field-in-field' technique (FP-IMRT) with an IP-IMRT alternative...
July 18, 2016: Journal of Medical Radiation Sciences
Xin Ming, Yuanming Feng, Chengwen Yang, Wei Wang, Ping Wang, Jun Deng
BACKGROUND: Radiation-induced heart disease (RIHD), which affects the patients' prognosis with both acute and late side effects, has been published extensively in the radiotherapy of breast cancer, lymphoma and other benign diseases. Studies on RIHD in lung cancer radiotherapy, however, are less extensive and clear even though the patients with lung cancer are delivered with higher doses to the heart during radiation treatment. METHODS: In this article, after extensive literature search and analysis, we reviewed the current evidence on RIHD in lung cancer patients after their radiation treatments and investigated the potential risk factors for RIHD as compared to other types of cancers...
October 2016: Medicine (Baltimore)
Luciana Lastrucci, Simona Borghesi, Silvia Bertocci, Chiara Gasperi, Andrea Rampini, Giovanna Buonfrate, Paola Pernici, Roberta De Majo, Pietro Giovanni Gennari
PURPOSE: To compare 3D-conformal radiotherapy (3D-CRT) treatment plans based on free-breathing (FB) and deep inspiration breath hold (DIBH) and investigated whether DIBH technique enables a decrease of cardiac left anterior descending coronary artery (LADCA) and lungs dose with respect to the FB. METHODS: Twenty-three left-sided breast cancer patients referred for breast radiotherapy were included. The planning target volume (PTV) encompassed the breast and organs at risk including heart, LADCA, lungs, and contralateral breast, which were contoured in FB and DIBH CT scans...
September 27, 2016: Tumori
Yunkyoung Lee, Hyun Jung Kim, Heeyoung Yoon, Chang Min Choi, Yeon Mok Oh, Sang Do Lee, Chae Man Lim, Woo Sung Kim, Younsuck Koh, Jae Seung Lee
Pulmonary artery sarcomas (PAS) are rare malignant neoplasms. Right heart failure due to tumour location is the main cause of death in PAS patients. The hemodynamic influence of PAS may effect prognosis, but this has not been proven. We aimed to identify the clinical characteristics and prognostic factors of PAS in Korea, their association with pulmonary hypertension (PH). PAS patients treated at the Asan Medical Center between 2000 and 2014 were reviewed. We examined demographic characteristics, diagnostic and treatment modalities...
November 2016: Journal of Korean Medical Science
Juan-Francisco Calvo-Ortega, Sandra Moragues, Miquel Pozo, Joan Casals
AIM: To investigate the viability of placing the treatment isocenter at the patient midline for breast cancer radiotherapy in order to avoid the risk of collisions during image-guided setup and treatment delivery. BACKGROUND: The use of kilovoltage orthogonal setup images has spread in last years in breast radiotherapy. There is a potential risk of an imaging system-patient collision when the isocenter is laterally placed. MATERIALS AND METHODS: Twenty IMRT plans designed by placing the isocenter within the breast volume ("plan_ref"), were retrospectively replanned by shifting the isocenter at the patient's midline ("plan_off-breast")...
November 2016: Reports of Practical Oncology and Radiotherapy
Mark T Nolan, David J Russell, Kazuaki Negishi, Thomas H Marwick
This investigation sought to identify and quantify any increased risk of long-term heart failure (HF) after thoracic radiotherapy (RT) for cancer and identify any population covariates that corresponded with increased risk. Electronic databases were systematically searched for studies reporting relative risk, odds ratio, and hazard ratio (HR) for symptomatic HF more than 5 years after RT administration. Clinical characteristics, study design, univariable effect sizes, and associated 95% CIs were extracted...
August 30, 2016: American Journal of Cardiology
Yoshihiko Uehara, Yasuhiko Murata, Soichiro Shiga, Yoshio Hosoi
BACKGROUND: It is well known that radiation exposure to the heart and the use of non-steroidal anti-inflammatory drugs (NSAIDs) increase the risk of myocardial infarction (MI). Some NSAIDs are also known to act synergistically with ionizing radiation and have radio-sensitizing effects in radiotherapy. These evidences suggest that NSAIDs may affect the risk of MI after radiation exposure to the heart. In the present study, we investigated effects of NSAIDs on radiation-induced expression of cell adhesion molecules and COX-2, which are associated with inflammation and an increased risk of MI, in human endothelial cells...
October 28, 2016: Biochemical and Biophysical Research Communications
Ilma Xhaferllari, Omar El-Sherif, Stewart Gaede
Volumetric-modulated arc therapy (VMAT) is emerging as a leading technology in treating early-stage, non-small cell lung cancer (NSCLC) with stereotactic ablative radiotherapy (SABR). However, two other modalities capable of deliver-ing intensity-modulated radiation therapy (IMRT) include fixed-beam and helical TomoTherapy (HT). This study aims to provide an extensive dosimetric compari-son among these various IMRT techniques for treating early-stage NSCLC with SABR. Ten early-stage NSCLC patients were retrospectively optimized using three fixed-beam techniques via nine to eleven beams (high and low modulation step-and-shoot (SS), and sliding window (SW)), two VMAT techniques via two partial arcs (SmartArc (SA) and RapidArc (RA)), and three HT techniques via three different fan beam widths (1 cm, 2...
2016: Journal of Applied Clinical Medical Physics
Scott R Silva, Murat Surucu, Jennifer Steber, Matthew M Harkenrider, Mehee Choi
OBJECTIVE: Radiation treatment planning for locally advanced lung cancer can be technically challenging, as delivery of ≥60 Gy to large volumes with concurrent chemotherapy is often associated with significant risk of normal tissue toxicity. We clinically implemented a novel hybrid RapidArc technique in patients with lung cancer and compared these plans with 3-dimensional conformal radiotherapy and RapidArc-only plans. MATERIALS/METHODS: Hybrid RapidArc was used to treat 11 patients with locally advanced lung cancer having bulky mediastinal adenopathy...
September 28, 2016: Technology in Cancer Research & Treatment
Nicholas J Slater, Her J H Zegers, Benno Küsters, Thimpe Beune, Henri A van Swieten, Dietmar J O Ulrich
BACKGROUND: Under ideal circumstances, creation of the anastomosis during free flap transfer is a routine task and can be performed under short ischemia time. However, vessels may be in suboptimal state due to atherosclerosis, radiotherapy or trauma, increasing difficulties regarding receptor vessel identification, and anastomosis which in turn may lead to lengthening of ischemia time resulting in postoperative wound problems or even flap loss. In the current pilot study, a modified heart-lung machine was assembled to achieve continuous oxygenated extracoporeal perfusion using porcine myocutaneous rectus abdominis flaps, aimed at minimizing tissue damage occurring during ischemia time...
October 2016: Journal of Surgical Research
Joshua Kim, Qixue Wu, Bo Zhao, Ning Wen, Munther Ajlouni, Benjamin Movsas, Indrin J Chetty
BACKGROUND: To compare retrospectively generated gated plans to conventional internal target volume (ITV)-based plans and to evaluate whether gated radiotherapy provides clinically relevant dosimetric improvements to organs-at-risk (OARs). METHODS: Evaluation was performed of 150 stereotactic ablative radiotherapy treatment plans delivered to 128 early-stage (T1-T3 (<5 cm)) NSCLC patients. To generate gated plans, original ITV-based plans were re-optimized and re-calculated on the end-exhale phase and using gated planning target volumes (PTV)...
2016: Radiation Oncology
Abolhasan Rezaeyan, Gholam Hassan Haddadi, Massood Hosseinzadeh, Maryam Moradi, Masoud Najafi
This study was carried out to evaluate radioprotective effects of hesperidin (HES) administration before the irradiation on the cardiac oxidative stress and histopathological changes in an experimental rat model. The cardiovascular complications of radiation exposure cause morbidity and mortality in patients who received radiotherapy. HES, an antioxidant flavonoid found in citrus fruits, suggests the protection against the tissue damage. Fifty-eight rats were divided into four groups: Group 1 received phosphate buffered saline (PBS) and sham radiation; Group 2, HES and sham radiation; Group 3, PBS and radiation; and Group 4, HES and radiation...
July 2016: Journal of Medical Physics
Gareth C Livingston, Andrew J Last, Thomas P Shakespeare, Patrick M Dwyer, Justin Westhuyzen, Michael J McKay, Lisa Connors, Stephanie Leader, Stuart Greenham
INTRODUCTION: For patients receiving radiotherapy for locally advance non-small cell lung cancer (NSCLC), the probability of experiencing severe radiation pneumonitis (RP) appears to rise with an increase in radiation received by the lungs. Intensity modulated radiotherapy (IMRT) provides the ability to reduce planned doses to healthy organs at risk (OAR) and can potentially reduce treatment-related side effects. This study reports toxicity outcomes and provides a dosimetric comparison with three-dimensional conformal radiotherapy (3DCRT)...
September 2016: Journal of Medical Radiation Sciences
Olivier Lauche, Youlia M Kirova, Pascal Fenoglietto, Emilie Costa, Claire Lemanski, Celine Bourgier, Olivier Riou, David Tiberi, Francois Campana, Alain Fourquet, David Azria
AIM: To analyse clinical and dosimetric results of helical tomotherapy (HT) and volumetric modulated arc therapy (VMAT) in complex adjuvant breast and nodes irradiation. METHODS: Seventy-three patients were included (31 HT and 42 VMAT). Dose were 63.8 Gy (HT) and 63.2 Gy (VMAT) in the tumour bed, 52.2 Gy in the breast, 50.4 Gy in supraclavicular nodes (SCN) and internal mammary chain (IMC) with HT and 52.2 Gy and 49.3 Gy in IMC and SCN with VMAT in 29 fractions...
August 28, 2016: World Journal of Radiology
Martje Marie Terheyden, Corinna Melchert, György Kovács
PURPOSE: This study aims to compare the dosimetric data of local tumor's bed dose escalation (boost) with photon beams (external beam radiation therapy - EBRT) versus high-dose-rate interstitial brachytherapy (HDR-BT) after breast-conserving treatment in women with early-stage breast cancer. MATERIAL AND METHODS: We analyzed the treatment planning data of 136 irradiated patients, treated between 2006 and 2013, who underwent breast-conserving surgery and adjuvant whole breast irradiation (WBI; 50...
August 2016: Journal of Contemporary Brachytherapy
Tejinder Kataria, Shyam Singh Bisht, Deepak Gupta, Ashu Abhishek, Trinanjan Basu, Kushal Narang, Shikha Goyal, Pragya Shukla, Manish Bansal, Hardeep Grewal, Kulbeer Ahlawat, Susovan Banarjee, Manoj Tayal
BACKGROUND: Radiotherapy for carcinoma of breast and thoracic structures involves inadvertent radiation to heart and coronary arteries (CA). Coronary artery stenosis in high radiation dose segments has been documented. Cardiac and respiratory motion induced displacement of CA and internal risk volume (IRV) margin remains inadequately quantified. MATERIAL AND METHODS: Twenty cases of carcinoma breast, lung and lung metastasis were enrolled in this study. ECG gated intravenous contrast enhanced computed tomography (CECT) scans were performed in inspiratory breath hold (IBH) and expiratory breath hold (EBH)...
September 15, 2016: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
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