Late Cardiac Effects of Therapeutic Mediastinal Irradiation

Gottdiener, John S.; Katin, Michael J.; Borer, J. S.; Bacharach, Stephen L.; Green, Michael V.

doi:10.1056/nejm198303103081005

Cited by 165 publications

(20 citation statements)

References 15 publications

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“…Burns et al (1983) found a 57% incidence of abnormal ventricular function, but those patients had recieved doses of irradiation of up to 76 Gy which excess the therapeutic range. A similar incidence of abnormalities of ventricular function was reported by Gottdiener et al (1983). Nevertheless, this group had been treated with a single anteroposterior field, a technique that is not commonly used.…”

Section: Discussionmentioning

confidence: 56%

“…Pohjola et al (1987) reported an incidence of 38% of pericardial effusion more than 5 years after mediastinal irradiation. Gottdiener et al (1983) gave 36%. However a pericar- (1976).…”

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severe, following mantle field irradiation, but many of these reports concern treatment techniques now considered as out of date (Applefeld et al, 1982;Do Pico et al, 1979;Gottdiener et al, 1983;Host & Yale, 1973;Larson et al, 1976;Lokich et al, 1973).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).…”

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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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: 56%

“…Pohjola et al (1987) reported an incidence of 38% of pericardial effusion more than 5 years after mediastinal irradiation. Gottdiener et al (1983) gave 36%. However a pericar- (1976).…”

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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“…[15][16][17][18] Pericarditis may be effusive or restrictive and present as an acute, chronic, or intermittent problem. Acutely, inflammation and increased vascular permeability may result in a pericardial effusion.…”

Section: Effects Of Radiation Therapymentioning

confidence: 99%

“…Up to 30% of patients with Hodgkin disease were noted to have a pericardial effusion during the 2 years after treatment. 15 Chronic pericardial disease may present as late as 10 years after treatment, often with symptoms of dyspnea. 19 It is believed that the incidence of pericarditis and other radiationinduced cardiac complications may be decreasing as a result of newer radiation therapy techniques and technology.…”

Section: Effects Of Radiation Therapymentioning

confidence: 99%

Medical Issues in Cancer Survivors—A Review

Miller

Triano

2008

The Cancer Journal

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Cancer survivorship is an emerging area of scientific and clinical interest. Several decades ago, most people diagnosed with cancer did not live long beyond their initial diagnosis. Today the number of cancer survivors exceeds ten million, and this group may experience unique healthcare issues related to their cancer treatment. Chemotherapy, surgery, and radiation therapy each have their own late and long-term complications. It is imperative for clinicians who are caring for cancer survivors to be aware of long-term complications of therapy and to treat these appropriately. When cancer therapy has successfully added years of life, it is equally as important that medical care assures the best quality of life during those years.

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