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• W2022859901 abstract "Tangential photon radiation treatment to the left breast/chest wall has been linked with cardiac dysfunction. In a prospective trial, we have demonstrated that new perfusion/functional defects occur 6–24 months post-RT (IJROBP 2003;57:S129) in ≈ 40% of patients. We herein assess the persistence of these regional and global cardiac defects 3–5 yrs post-RT. Between 1998–2003, 130 patients with left-sided breast cancer were enrolled onto an IRB-approved prospective study to assess RT-induced cardiac dysfunction. All patients received tangent photons to 46–50 Gy, 1.8-2Gy/Fx. Patients had pre- and serial post-RT single photon emission computed tomography (SPECT) scans to assess changes in regional cardiac perfusion, wall motion and ejection fraction. SPECT images were acquired 30–60 min after I.V. administration of 25–30 mCi Tc-99m labeled myocardial perfusion tracer. Patients with pre-RT abnormal perfusion were excluded from this analysis. The findings in 32 patients with follow-up scans 3–5 years post-RT are herein reported to assess long-term RT-induced cardiac dysfunction. These 32 patients are divided into several subgroups based on their 6–24 month post-RT scans. In patients whose 6–24 month post-RT perfusion scans were consistently abnormal, 7/9 (78%) had persistent perfusion defects 3–5 years post-RT. In patients whose 6–24 months post-RT perfusion was intermittently abnormal (i.e. some scans normal, others abnormal), 5/11 (45%) had perfusion defects 3–5 years post RT. In patients whose perfusion 6–24 months post-RT were all normal, 7/12 (58%) had abnormal scans 3–5 years post RT. Among those patients with a perfusion defect 3–5 years post-RT, corresponding abnormalities in wall motion were seen in 3/19. Similarly, declines in EF >5% were seen in 3/19 patients. For comparison, the rates of wall motion abnormalities and declines in EF >5% in patients with perfusion defects 6–24 months post RT were 7/20 and 2/20. RT-induced perfusion defects can persist 3–5 years post-RT, and appear associated with abnormalities in ejection fraction and regional wall motion. The clinical relevance of these perfusion defects remains unclear. However, it is possible that such RT-induced perfusion defects represent subclinical microvascular injury, which may render the patients at increased risk for ischemic heart disease. Additional follow-up and study is required to better understand the persistence and functional consequences of RT-induced cardiac dysfunction." @default.
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• W2022859901 date "2004-09-01" @default.
• W2022859901 modified "2023-10-12" @default.
• W2022859901 title "Persistence of radiation (RT)-induced cardiac dysfunction 3–5 years post RT" @default.
• W2022859901 doi "https://doi.org/10.1016/j.ijrobp.2004.07.257" @default.
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