Pathophysiologic Impact of Doxorubicin and Radiation Therapy on the Heart of Patients Treated for Breast Cancer
Annual rept. 1 Jul 1998-30 Jun 1999
DUKE UNIV MEDICAL CENTER DURHAM NC
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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 heartleft 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.
- Anatomy and Physiology
- Medicine and Medical Research