The effect of ionizing radiation through cardiac stereotactic body radiation therapy on myocardial tissue for refractory ventricular arrhythmias: A review

被引:12
|
作者
Whitaker, John [1 ,2 ,3 ]
Zei, Paul C. [1 ,2 ]
Ahmad, Shahreen [3 ,4 ]
Niederer, Steven [3 ]
O'Neill, Mark [3 ]
Rinaldi, Christopher A. [3 ]
机构
[1] Brigham & Womens Hosp, Boston, MA 02115 USA
[2] Harvard Med Sch, Boston, MA 02115 USA
[3] Kings Coll London, Sch Biomed Engn & Imaging Sci, London, England
[4] Guys & St Thomass NHS Fdn Trust, London, England
来源
FRONTIERS IN CARDIOVASCULAR MEDICINE | 2022年 / 9卷
基金
英国惠康基金;
关键词
cardiac stereotactic body radiation therapy; ventricular tachycardia; cellular response; cardiomyopathy; ablation electrophysiology; CATHETER-FREE ABLATION; BETA-RADIATION; RADIOSURGERY; RADIOTHERAPY; HEARTS; CREATION; LESIONS;
D O I
10.3389/fcvm.2022.989886
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Cardiac stereotactic body radiation therapy (cSBRT) is a non-invasive treatment modality that has been recently reported as an effective treatment for ventricular arrhythmias refractory to medical therapy and catheter ablation. The approach leverages tools developed and refined in radiation oncology, where experience has been accumulated in the treatment of a wide variety of malignant conditions. However, important differences exist between rapidly dividing malignant tumor cells and fully differentiated myocytes in pathologically remodeled ventricular myocardium, which represent the respective radiation targets. Despite its initial success, little is known about the radiobiology of the anti-arrhythmic effect cSBRT. Pre-clinical data indicates a late fibrotic effect of that appears between 3 and 4 months following cSBRT, which may result in conduction slowing and block. However, there is clear clinical evidence of an anti-arrhythmic effect of cSBRT that precedes the appearance of radiation induced fibrosis for which the mechanism is unclear. In addition, the data to date suggests that even the late anti-arrhythmic effect of cSBRT is not fully attributable to radiation.-induced fibrosis. Pre-clinical data has identified upregulation of proteins expected to result in both increased cell-to-cell coupling and excitability in the early post cSBRT period and demonstrated an associated increase in myocardial conduction velocity. These observations indicate a complex response to radiotherapy and highlight the lack of clarity regarding the different stages of the anti-arrhythmic mechanism of cSBRT. It may be speculated that in the future cSBRT therapy could be planned to deliver both early and late radiation effects titrated to optimize the combined anti-arrhythmic efficacy of the treatment. In addition to these outstanding mechanistic questions, the optimal patient selection, radiation modality, radiation dose and treatment planning strategy are currently being investigated. In this review, we consider the structural and functional effect of radiation on myocardium and the possible anti-arrhythmic mechanisms of cSBRT. Review of the published data highlights the exciting prospects for the development of knowledge and understanding in this area in which so many outstanding questions exist.
引用
收藏
页数:12
相关论文
共 50 条
  • [41] Stereotactic body radiation therapy in non-liver colorectal metastases: a scoping review
    Teriaca, Maria Ausilia
    Massaro, Maria
    Franzese, Ciro
    Comito, Tiziana
    Scorsetti, Marta
    JOURNAL OF GASTROINTESTINAL ONCOLOGY, 2024, 15 (04) : 1908 - 1916
  • [42] Effect of Immunotherapy and Stereotactic Body Radiation Therapy Sequencing on Local Control and Survival in Patients With Spine Metastases
    Eckstein, Jacob
    Gogineni, Emile
    Sidiqi, Baho
    Lisser, Noah
    Parashar, Bhupesh
    ADVANCES IN RADIATION ONCOLOGY, 2023, 8 (03)
  • [43] Stereotactic Body Radiation Therapy Versus Conventional Radiation Therapy in Pain Relief for Bone Metastases: A Systematic Review and Meta-Analysis
    Song, Xing
    Wei, Jun
    Sun, Rui
    Jiang, Wenjie
    Chen, Yuan
    Shao, Yingjie
    Gu, Wendong
    INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2023, 115 (04): : 909 - 921
  • [44] Fine-tuning the normal tissue objective in eclipse for lung stereotactic body radiation therapy
    Bell, James P.
    Patel, Pretesh
    Higgins, Kristin
    McDonald, Mark W.
    Roper, Justin
    MEDICAL DOSIMETRY, 2018, 43 (04) : 344 - 350
  • [45] Robotic Stereotactic Body Radiation Therapy for Oligometastatic Liver Metastases: A Systematic Review of the Literature and Evidence Quality Assessment
    Kyrochristou, Ilektra
    Giannakodimos, Ilias
    Tolia, Maria
    Georgakopoulos, Ioannis
    Pararas, Nikolaos
    Mulita, Francesk
    Machairas, Nikolaos
    Schizas, Dimitrios
    DIAGNOSTICS, 2024, 14 (10)
  • [46] The Effect of Stereotactic Body Radiation Therapy for Hepatocellular Cancer on Regional Hepatic Liver Function
    Wei, Lise
    Simeth, Josiah
    Aryal, Madhava P.
    Matuszak, Martha
    Ten Haken, Randall K.
    Cuneo, Kyle
    Lawrence, Theodore S.
    Cao, Yue
    INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2023, 115 (03): : 794 - 802
  • [47] Histopathologic and Ultrastructural Findings in Human Myocardium After Stereotactic Body Radiation Therapy for Recalcitrant Ventricular Tachycardia
    Kiani, Soroosh
    Kutob, Leila
    Schneider, Frank
    Higgins, Kristin A.
    Lloyd, Michael S.
    CIRCULATION-ARRHYTHMIA AND ELECTROPHYSIOLOGY, 2020, 13 (11) : E008753
  • [48] The Effect of Video-Based Education on Anxiety of Patients Receiving Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy
    Esen, Caglayan Selenge Beduk
    Yazici, Gozde
    Hurmuz, Pervin
    Ozyigit, Gokhan
    Zorlu, Faruk
    JOURNAL OF CANCER EDUCATION, 2023, 38 (02) : 426 - 430
  • [49] Radiation therapy-induced left vocal cord paralysis following lung stereotactic body radiation therapy: A case report and review of the literature
    Pierrard, J.
    Deheneffe, S.
    Longton, E.
    Henry, S.
    Van Houtte, P.
    Remouchamps, V.
    CANCER RADIOTHERAPIE, 2023, 27 (01): : 69 - 74
  • [50] Stereotactic body radiation therapy for early-stage hepatocellular carcinoma - a systematic review on outcome
    Dobrzycka, M.
    Spychalski, P.
    Rostkowska, O.
    Wilczynski, M.
    Kobiela, P.
    Grat, M.
    Dell'Acqua, V.
    Hoyer, M.
    Jereczek-Fossa, B. A.
    ACTA ONCOLOGICA, 2019, 58 (12) : 1706 - 1713