Document Detail

Symptomatic cardiac events following radiation therapy for left-sided breast cancer: possible association with radiation therapy-induced changes in regional perfusion.
MedLine Citation:
PMID:  14499012     Owner:  NLM     Status:  MEDLINE    
Our group has demonstrated that tangential radiation therapy (RT) to the left breast or chest wall can cause perfusion changes in the anterior myocardium. We assess if RT-induced perfusion changes are associated with the development of symptoms consistent with cardiac dysfunction. Between 1998 and 2001, 114 patients were enrolled into an institutional review board-approved prospective study and had pre-RT and serial post-RT (range, 6-24 months) single photon emission computed tomography (SPECT) scans to assess changes in regional cardiac perfusion. Thirty-one patients were excluded. The incidence of cardiac symptoms in patients with and without RT-induced perfusion defects was compared using a 2-tailed Fisher's exact test. With a median follow-up of 16 months (range, 6-24 months), 10 of 83 evaluable patients had > or = 1 episode of transient chest pain, occurring 0-14 months after RT (median, 6 months). The rates of chest pain in the patients with and without new perfusion defects were 9 of 31 and 1 of 52, respectively (P = 0.0004). A similar result was found when patients were segregated based on the use of chemotherapy. Two of these 10 cases were diagnosed as pericarditis. No patient had myocardial infarction or congestive heart failure. Cardiac symptoms occur more frequently in patients with perfusion abnormalities by SPECT after RT than in patients with normal SPECT scans, suggesting that such perfusion defects may be clinically significant. One confounding factor is that women who know they have RT-induced perfusion defects may be more likely to report episode of chest pain. Long-term follow-up will be necessary to better assess the clinical significance of RT-induced perfusion defects.
Xiaoli Yu; Robert R Prosnitz; Sumin Zhou; Patricia H Hardenberg; Andrea Tisch; Michael A Blazing; Salvador Borges-Neto; Donna Hollis; Terence Wong; Lawrance B Marks
Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Clinical breast cancer     Volume:  4     ISSN:  1526-8209     ISO Abbreviation:  Clin. Breast Cancer     Publication Date:  2003 Aug 
Date Detail:
Created Date:  2003-09-22     Completed Date:  2003-12-23     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  100898731     Medline TA:  Clin Breast Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  193-7     Citation Subset:  IM    
Department of Radiation Oncology, Duke University Medical Center, Durham, NC 27710, USA.
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MeSH Terms
Breast Neoplasms / radiotherapy*
Coronary Artery Disease / physiopathology*,  radionuclide imaging
Coronary Circulation / physiology,  radiation effects*
Middle Aged
Prospective Studies
Radiation Injuries / physiopathology*,  radionuclide imaging
Radiotherapy / adverse effects
Tomography, Emission-Computed, Single-Photon

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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