Effects on the Cardiovascular System of Irradiation for Malignant Lymphoma

Le, Larsson; Lindahl, J; Unsqaard, B

doi:10.3109/02841867609131977

Cited by 9 publications

(4 citation statements)

References 15 publications

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“…The linear accelerator of 25 MV used, gives a lower dose to the heart than 'Co or 8 MV LinAc as described in other studies (Brosius et al, 1981;Carmel & Kaplan, 1976;Cosset et al, 1984;La Monte et al, 1986;Larson et al, 1976;McReynolds et al, 1976;Pohjola-Sintonen et al, 1987;Watchie et al, 1987;Zarrabi et al, 1984); 1.8 Gy to a maximum of 2 Gy per fraction, five fractions per week, the two fields being treated every day, all these precautions are probably important to reduce late sequelae. Nevertheless, our follow-up is still too short to conclude.…”

Section: Discussionmentioning

confidence: 99%

“…Generally, a 25% incidence of findings including ST segment depression, T wave changes, minor QRS abnormalities and occasional silent myocardial infarction are reported (Brosius et al, 1981;LaMonte et al, 1986;Larson et al, 1976;McReynolds et al, 1976;Pohjola-Sintonen et al, 1987;Watchie et al, 1987;Zarrabi et al, 1984). Watchie et al (1987) found a 13% incidence of complete or incomplete right bundle branch blocks.…”

Section: Discussionmentioning

confidence: 99%

“…The follow-up of the patients in our series lasted more than 2 years and can explain our low sequelae level. Host et al (1973) and Larson et al (1976) evaluated the effects of mantle irradiation and found a mild restrictive ventilatory impairment marked by a decrease in lung volume at 9-23 months. Smith et al (1989) confirmed acute changes in lung volumes and spirometry after mantle irradiation, which resolve within 2 years and are not of sufficient degree to cause symptomatology or to extend outside the range of normal.…”

Section: Discussionmentioning

confidence: 99%

“…The literature contains a number of reports on both cardiac and pulmonary complications, often severe, following mantle field irradiation, but many of these reports concern treatment techniques now considered as out of date (Applefeld et al, 1982;Do Pico et al, 1979;Gottdiener et al, 1983;Host & Yale, 1973;Larson et al, 1976;Lokich et al, 1973). More recent data suggest a dramatic decrease in these sequelae over the past decade as a result of refined treatment techniques (Carmel & Kaplan, 1976;Morgan et al, 1985;Smith et al, 1989).…”

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confidence: 99%

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Late cardiopulmonary toxicity after treatment for Hodgkin's disease

Allavena

Conroy²,

Aletti³

et al. 1992

Br J Cancer

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Summary Cardiac and pulmonary functions were evaluted in 75 patients aged 50 years or under, treated for Hodgkin's disease by mantle radiotherapy at least 3 years earlier; all received the same mantle field radiotherapy: radiotherapy alone, MOPP chemotherapy plus radiotherapy, MOPP and ABVD chemotherapy plus radiotherapy.No patient had any symptom of heart disease. Only borderline abnormalities of ECG or echocardiogram were observed in 12 patients. One of them showed a moderate aortic stenosis which was known before the treatment; apical or septum hypokinesia were present in four patients and one patient had a slightly right ventricular dilatation.Twelve (16%) chest radiographs showed moderate or severe abnormalities, but there was no significant correlation between the results of pulmonary function tests and Xenon ventilation/perfusion scintigraphy, the clinical examination and the intensity of the radiological sequelae. Twenty-nine (64%) Xenon scintigraphies showed a reduction of lung perfusion in the irradiated areas without any symptom. The resting mean pulmonary function test was significantly lower for the patients than for the control group with regard to Total Capacity and Vital Capacity. The exercise tolerance, as indicated by analysis of blood gases, was below the one expected for only two patients who were dyspneic during the low level of exercise. We did not find any significant difference between the three treatment groups.We conclude that the treatment with mantle field under good technical conditions (high energy photons, moderate doses ...) can result in minimal cardiopulmonary dysfunction.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Late cardiopulmonary toxicity after treatment for Hodgkin's disease

Allavena

Conroy²,

Aletti³

et al. 1992

Br J Cancer

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Cardiac disease after mediastinal irradiation for seminoma

Lederman¹,

Sheldon²,

Chaffey³

et al. 1987

Cancer

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One hundred twenty-four patients with seminoma (119 primary testis, five primary extragonadal) were treated between 1968 and 1984 at the Joint Center for Radiation Therapy. Fifty-seven of the 124 patients were treated with irradiation to the mediastinum as well as to an infradiaphragmatic field. One patient received supradiaphragmatic radiotherapy only. The remaining patients had radiation treatment limited to the infradiaphragmatic field only. Median dose to the mediastinum among the 58 patients was 2400 cGy. Four patients developed heart disease (one fatal myocardial infarction, one uncomplicated myocardial infarction, one constrictive pericarditis resulting in permanent total body anasarca, and one patient requiring aortic valve replacement and coronary artery bypass grafting for atherosclerotic disease) and two died suddenly. The two sudden deaths were thought to be cardiac in origin by the patient's primary physicians. All six complications occurred in the group that received mediastinal irradiation. No cardiac disease was manifested in the group not treated with mediastinal irradiation. This difference in the incidence of cardiac disease between the two groups is statistically significant (two sided, P = 0.019). Neither group had a statistically significant difference in cardiac disease rate from a normal population (Framingham study), although the ratio of observed to expected cardiac disease was 1.97 in the group receiving mediastinal radiation. Further experience from this and other institutions is necessary to confirm this finding.

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Heart

Schultz-Hector

1991

Medical Radiology

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Effects on the Cardiovascular System of Irradiation for Malignant Lymphoma

Cited by 9 publications

References 15 publications

Late cardiopulmonary toxicity after treatment for Hodgkin's disease

Late cardiopulmonary toxicity after treatment for Hodgkin's disease

Cardiac disease after mediastinal irradiation for seminoma

Heart

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