Pathophysiologic Impact of Doxorubicin and Radiation Therapy on the Heart of Patients Treated for Breast Cancer
Abstract
To determine the incidence and dose-dependence of regional cardiac perfusion abnormalities in patients with left-sided breast cancer treated with radiation therapy (RT) with and without doxorubicin. 114 patients with left-sided breast cancer underwent cardiac perfusion imaging using single photon emission computed tomography (SPECT) pre-RT. Post-RT images were obtained in 80, 47 23 and 9 patients 6, 12, 18, and 24 months post-RT. SPECT perfusion images were registered onto three-dimensional (3D) RT dose distributions. The volume of heart in the RT field was quantified and the regional RT dose was calculated. A decrease in regional cardiac perfusion was assessed subjectively by visual inspection and objectively using image fusion software. Overall. 40% of patients developed RT-induced perfusion defects. The incidence of such defects increased with increasing volumes of the heart irradiated, increasing duration of follow-up, and were more prevalent in African American patient (vs caucasians) and in those receiving chemotherapy (vs. RT alone). The severity of the defects appears to be dose-dependent. No events of myocardial infarction (MI) or congestive heart failure (CHF) have occurred GAMMA causes dose-dependent cardiac perfusion defects 6-24 months post-RT in most patients. The use of chemotherapy and African an race may increase this rate Long-term follow-up is needed to assess whether these perfusion changes are transient or permanent and mine if these findings are associated with changes in overall cardiac function and clinical outcome.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jul 01, 2001
- Accession Number
- ADB282142
Entities
People
- Lawrence B. Marks
Organizations
- Duke University Hospital