Pathophysiologic Impact of Doxorubicin and Radiation Therapy on the Heart of Patients Treated for Breast Cancer
Abstract
The purpose of this research is to assess the incidence and extent of radiation induced regional cardiac perfusion defects and functional abnormalities in patients with left-sided breast cancer following RT with and without chemotherapy. Methods: Fifty-one patients with left-sided breast cancer have undergone pre-treatment (SPECT) cardiac perfusion scans to evaluate regional myocardial perfusion and cardiac function by LVEF. At six month intervals the patients have follow-up perfusion scans and physical exams for a minimum of 2 years. Radiation doses and heart/left ventricle volumes are calculated on a computed tomography (CT) based 3-D treatment planning system (PLUNC). Results: Thirteen patients have had a 6 month follow-up cardiac perfusion scan. Eight of thirteen patients have a new visibly detectable perfusion defect on the post radiation scan in the anterior region of the left ventricle which correlates with the tangential radiation beams. There appears to be a dose-dependent change with a 20% reduction in perfusion in the volume of heart receiving 40-50 Gy. No patient has had a change in their LVEF or evidence of functional defect in the heart. Conclusion: It appears that radiation causes a dose-dependent regional cardiac perfusion defect in 60% of patients studied. To date these changes do not correlate with function or clinical sequelae.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jul 01, 1999
- Accession Number
- ADB261351
Entities
People
- Patricia H. Hardenberg
Organizations
- Duke University Hospital