The clinical implications of myocardial perfusion abnormalities in patients with esophageal or lung cancer after chemoradiation therapy

Abstract

Cardiac complications after CRT are more common in esophageal than lung cancer patients but the difference is not statistically significant. MPI abnormalities are frequently seen after CRT but are not predictive of future cardiac complications. A history of arrhythmia or CHF is significantly associated with cardiac complications after CRT.

Is cardiac toxicity a relevant issue in the radiation treatment of esophageal cancer?

“…In another study from the same investigators, the clinical implications of these perfusion abnormalities in 24 lung and 16 esophageal cancer patients were investigated [10]. Although new perfusion defects were seen in about 1/3 of the patients, no significant relationship was found with symptomatic cardiac complications after a rather short median follow up of 10.9 months.…”

“…3D functional cardiac imaging was used to evaluate cardiac toxicity in five papers [10][11][12][13][14]. Treatment details and patient numbers are again listed and marked as the last five papers in Table 1.…”

Medical anticancer treatment of lung cancer associated with comorbidities: A review

“…A preexisting history of congestive heart failure or arrhythmia prior to the diagnosis of lung cancer treated by radiochemotherapy has to be associated to the occurrence of future cardiac complications [7]. New ischemic changes or arrhythmias were documented but none were fatal.…”

Volumetric modulated arc therapy planning for distal oesophageal malignancies

“…There are data [10] documenting clinically manifested cardiac morbidity in up to 44% of the patients, and heart irradiated to 30 Gy (V30) .46% was predictive of cardiac complications [11]. We have demonstrated a reduction in heart V40 and V45 with changes in the number and arrangement of beams in this site previously [12], using conformal planning.…”