Radiation-associated cardiovascular disease

Adams, Michael; Hardenbergh, Patricia H.; Constine, Louis S.; Lipshultz, Steven E.

doi:10.1016/s1040-8428(01)00227-x

Cited by 461 publications

(315 citation statements)

References 130 publications

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“…Diastolic Dysfunction and Trastuzumab early myocardial capillary damage is unclear, these defects may eventually lead to myocardial fibrosis and ultimately, diastolic dysfunction [27]. In this study, we found a higher prevalence of LVDD in patients receiving concurrent treatment than RT alone, although the difference was not statistically significant (35.2% versus 19.7%, p 5 .061).…”

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confidence: 50%

Diastolic Dysfunction Occurs Early in HER2-Positive Breast Cancer Patients Treated Concurrently With Radiation Therapy and Trastuzumab

et al. 2015

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Background. Left ventricular ejection fraction (LVEF) is used routinely to monitor cardiac dysfunction associated with breast cancer treatment. In this study the prevalence of early left ventricular diastolic dysfunction (LVDD) and its relationship to the dose-volume of the heart irradiated were evaluated in HER2-positive breast cancer patients undergoing concurrent trastuzumab and adjuvant radiotherapy (RT). Materials and Methods. Data from 40 breast cancer patients treated with concurrent trastuzumab and left-sided adjuvant RT between September 2011 and October 2012 were collected prospectively. For comparison, 32 patients treated with concurrent trastuzumab and right-sided adjuvant RT and 71 patients treated with left-sided RT alone were collected retrospectively. Echocardiography was obtained before RT, immediately following RT, and 3 and 6 months after RT. Doses to the heart and left ventricle (LV) were quantified.

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Diastolic Dysfunction Occurs Early in HER2-Positive Breast Cancer Patients Treated Concurrently With Radiation Therapy and Trastuzumab

et al. 2015

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“…Acute and late cardiopulmonary toxicity due to CRT is a critical issue (34)(35)(36) and is observed in 2-10% of the patients according to previous reports (6,7,(8)(9)(10)(11). To prevent it, not only the improvement of radiation techniques, but also a reduction of the radiation dose to the esophagus, heart and lung are important.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Submucosal Dissection (ESD) with Additional Therapy for Superficial Esophageal Cancer with Submucosal Invasion

et al. 2015

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Objective The standard treatment for submucosal esophageal cancer is esophagectomy or chemoradiotherapy (CRT). However, these treatment modalities could deteriorate the general condition and quality of life of the patients who are intolerant to invasive therapy. It is therefore important and beneficial to develop less invasive treatment protocols for these patients. Methods The study included 43 patients who were clinically suspected of mucosa or submucosal esophageal cancer but underwent endoscopic submucosal dissection (ESD) as a primary treatment, due to the patients' poor performance statuses and/or preferences for less invasive therapy. According to the pathological findings and patient's general condition, whether the patient underwent additional treatments or remained hospitalized without additional treatments was thereafter decided for each patient. We retrospectively analyzed the outcomes of these patients. Results Fifteen patients underwent additional surgery, 11 patients underwent CRT/radiation therapy (RT) and 17 patients were followed without additional treatments. During the 3-year follow-up period, the relapsefree survival rates in the patients who received or did not receive additional treatments were 88% and 64%, respectively (95% confidence interval, 0.45-0.76, p=0.04). The relapse-free and overall survival rates in the patients with additional treatments were equivalent or superior to those described in previous reports of the standard treatments. Preceding ESD contributed to reduce the local relapse significantly to approximately 3.5% and additional CRT-related toxicities. Conclusion Preceding ESD is very effective for the local control of cancer, and useful for histologically confirming the high-risk factors of relapse, such as ! submucosal layer 2 (SM2) invasion and lymphovascular involvements. ESD with additional therapy may be a promising strategy for optimizing the selection of therapy depending on the patient's general condition.

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“…In the classical form of this treatment, considerable parts of the heart are in the primary beam and receive doses over 40 Gy (fractionated). The report by Kodama in the early 1990s of a significant dose-related increase in deaths from heart diseases among Japanese A-bomb survivors observed in the Life Span Study, which was compatible with a linear non-threshold dose-risk relationship [3], stimulated a large number of epidemiological and clinical research activities, e. g. in patients treated for nonmalignant disorders such as peptic ulcer by Carr et al [4] or in many other Hodgkin's disease cohorts [5][6][7]. The most important studies addressed the cardiovascular disease risk of patients who had been cured from breast cancer by postoperative radiotherapy [8,9].…”

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confidence: 99%

Some considerations for future research into the risks of radiation-induced cardiovascular diseases

Trott

2016

Strahlenther Onkol

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Radiation-associated cardiovascular disease

Cited by 461 publications

References 130 publications

Diastolic Dysfunction Occurs Early in HER2-Positive Breast Cancer Patients Treated Concurrently With Radiation Therapy and Trastuzumab

Diastolic Dysfunction Occurs Early in HER2-Positive Breast Cancer Patients Treated Concurrently With Radiation Therapy and Trastuzumab

Endoscopic Submucosal Dissection (ESD) with Additional Therapy for Superficial Esophageal Cancer with Submucosal Invasion

Some considerations for future research into the risks of radiation-induced cardiovascular diseases

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