Screening for Coronary Artery Disease After Mediastinal Irradiation for Hodgkin's Disease

Heidenreich, Paul A.; Schnittger, Ingela; Strausś, H. William; Vagelos, Randall H.; Lee, Byron K.; Mariscal, Carol; Tate, David J.; Horning, Sandra J.; Hoppe, Richard T.; Hancock, Steven

doi:10.1200/jco.2006.07.0805

Cited by 241 publications

(144 citation statements)

References 40 publications

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“…Most of the patients with cardiac ischemia did not have anginal complaints. These findings are in agreement with the study of Marks et al [9], Heidenreich et al [13,14] and the Dutch Late Effects Breast Cancer Cohort, which studied the effects of cardiovascular toxicity of radiation therapy in women with breast cancer during a period of 10 years [15,16] and the SEER database [17]. The latter was a large study of women, who survived breast cancer treated with radiation therapy.…”

supporting

confidence: 89%

Cardiac perfusion screening in patients to be treated with radiation therapy in the chest, is it a must?

Baur

2009

Int J Cardiovasc Imaging

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supporting

confidence: 89%

Cardiac perfusion screening in patients to be treated with radiation therapy in the chest, is it a must?

Baur

2009

Int J Cardiovasc Imaging

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“…Studies of cardiovascular function in symptomatic and asymptomatic HL survivors have shown increased frequency of valvular sclerosis and other aberrant findings. 6,[11][12][13][14][15] This is higher than reported in the general population. 16,17 It has been difficult to disentangle if these changes are clinically relevant and what investigations could be suitable for screening.…”

contrasting

confidence: 50%

Long‐term risk of cardiovascular disease in Hodgkin lymphoma survivors—Retrospective cohort analyses and a concept for prospective intervention

Andersson

Näslund

Tavelin

et al. 2009

Intl Journal of Cancer

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Previous studies have shown increased cardiovascular mortality as late side effects in Hodgkin lymphoma (HL) patients. This study identifies stratifying risk factors for surveillance and defines concepts for a clinical feasible and noninvasive prospective protocol for intervention of cardiovascular side effects. HL patients diagnosed between 1965 and 1995 (n 5 6.946) and their first-degree relatives (FDR) were identified through the Swedish Cancer Registry and the Swedish Multigeneration Registry. For the HL and FDR cohort, in-patient care for cardiovascular disease (CVD) was registered through the Hospital Discharge Registry, Sweden. Standard incidence ratios of developing CVD for the HL cohort were calculated. A markedly increased risk for in-patient care of CVD was observed in HL patients with HL diagnosed at age 40 years or younger and with more than 10 years follow-up. In the HL survivors, a family history of congestive heart failure (CHF) and coronary artery disease (CAD) increased the risk for these diseases. The Swedish Hodgkin Intervention and Prevention study started in 2007. In the pilot feasibility study for prospective intervention (47 patients), about 25% of the cases had side effects and laboratory abnormalities. These patients were referred to a cardiologist or general practitioner. In the prospective cohort, a positive family history for CHF or CAD could be a stratifying risk factor when setting up a surveillance model. The prospective on-going study presents an intervention model that screens and treats for comorbidity factors. This article also presents an overview of the study concept.

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“…The risk of radiation-induced secondary cancer in children with cholangiocarcinoma treated with RT was also found to be the highest after X-ray therapy, and the lowest after intensive proton therapy (69). The increased risk of coronary artery disease and valvular dysfunction was found to be associated with cardiac irradiation during X-ray treatment of Hodgkin's lymphoma (70,71). Therefore, in order to reduce the morbidity, mortality, pain and health care costs of Hodgkin's lymphoma survivors, PBT may be a feasible option.…”

Section: Pbt For Different Cancersmentioning

confidence: 85%

The evolution of proton beam therapy: Current and future status (Review)

et al. 2017

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Abstract. Proton beam therapy (PBT) has been increasingly used in a variety of cancers due to its excellent physical properties and superior dosimetric parameters. PBT may improve patient survival by improving the local tumor treatment rate while reducing injury to normal organs, which may result in fewer radiation-induced adverse effects. However, the significant cost of establishing and maintaining proton facilities cannot be overlooked. In addition, there has been significant controversy regarding routine application of this treatment in certain types of cancer. The challenges of PBT in the future mainly include the lack of basic clinical trials, unclear biological effects, immature imaging technology and miniaturization of imaging guidance. Overcoming these limitations may promote the rapid development of PBT. We herein provide an overview of the existing literature on the efficacy and toxicity of common oncological applications of proton beam therapy.

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Screening for Coronary Artery Disease After Mediastinal Irradiation for Hodgkin's Disease

Abstract: Stress-induced signs of ischemia and significant coronary artery disease are highly prevalent after mediastinal irradiation in young patients. Stress testing identifies asymptomatic individuals at high risk for acute myocardial infarction or sudden cardiac death.

Cited by 241 publications

References 40 publications

Cardiac perfusion screening in patients to be treated with radiation therapy in the chest, is it a must?

Cardiac perfusion screening in patients to be treated with radiation therapy in the chest, is it a must?

Long‐term risk of cardiovascular disease in Hodgkin lymphoma survivors—Retrospective cohort analyses and a concept for prospective intervention

The evolution of proton beam therapy: Current and future status (Review)

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