Treatment Related Cardiac Toxicity in Patients Treated for Breast Cancer
Abstract
To determine the incidence, dose/time-dependence, and functional significance of regional cardiac perfusion abnormalities in patients with left-sided breast cancer treated with radiation therapy (RT) with and without doxorubicin Methods: 126 patients underwent pre-RT single photon emission computed tomography (SPECT) cardiac perfusion imaging. Post RT images were obtained iii 97, 69,42, 30,13 and 8 patients 6, 12, 18, 24, 36 and 48 months post-RT. SPECT perfusion images were registered onto 3-dimensional (3D) RT dose distributions. The volume of heart in the RT field was quantified and the regional RT dose was calculated. Changes in regional and global cardiac function were assessed. Results: Overall, 30% of patients developed dose-dependent RT-induced perfusion defects. The incidence of defects increased with the volumes of heart irradiated, and maybe more prevalent in African Americans (vs. Caucasians) and with chemotherapy (vs. RT alone). Perfusion defects were associated with changes in regional wall motion 20-40% of the time and possibly with the development of chest-pain Conclusions: RT causes dose dependent-cardiac perfusion defects 6-24 months post-RT that appears to be associated with functional changes. The use of chemotherapy and African American race may increase this rate. Long-term follow-up is needed to assess whether these perfusion changes are transient or permanent and to determine if these findings are associated with changes in overall cardiac function and clinical outcome.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jun 01, 2003
- Accession Number
- ADA418672
Entities
People
- Lawrence B. Marks
Organizations
- Duke University