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Treatment Related Cardiac Toxicity in Patients Treated for Breast Cancer

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Annual rept. 1 Jun 2004-31 May 2005

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To determine the incidence, dosetime-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 153 patients underwent pre-RT single photon emission computed tomography SPECT cardiac perfusion imaging. Post RT images were obtained in 121, 88,49,31,22,27,21, and 2 patients at 6, 12, 18,24,36,48, 60, and 72 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. The incidence of new perfusion defects 6,12,18, and 24 months post RT is 34, 37, 36, and 42 respectively. in the 44 pts who have longer follow-up beyond 2 years, 3044 68 exhibit perfusion defects. New defects occurred in approximately 1030 and 4060 of patients with 5 and 5 of their left ventricle included within the RT fields, respectively. Perfusion defects were associated with changes in regional wall motion 12-29 of the time and possibly with the development of chest-pain. Patients with extensive perfusion defects may have subtle reductions in ejection fractions. RT causes volume-dependent perfusion defects in approximately 42 of patients within two years of RT. These perfusion defects largely persist beyond 2 years and are associated with corresponding wall motion abnormalities and possibly reductions in ejection fraction.

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  • Medicine and Medical Research
  • Radiobiology

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