ACUTE RADIATION EFFECTS ON CARDIAC FUNCTION DETECTED BY STRAIN RATE IMAGING IN BREAST CANCER PATIENTS

被引:120
作者
Erven, Katrien [1 ]
Jurcut, Ruxandra [4 ]
Weltens, Caroline [1 ]
Giusca, Sorin
Ector, Joris [2 ]
Wildiers, Hans [3 ]
Van den Bogaert, Walter [1 ]
Voigt, Jens-Uwe [2 ]
机构
[1] Univ Hosp Gasthuisberg, Dept Radiotherapy, B-3000 Louvain, Belgium
[2] Univ Hosp Gasthuisberg, Dept Cardiol, B-3000 Louvain, Belgium
[3] Univ Hosp Gasthuisberg, Dept Med Oncol, B-3000 Louvain, Belgium
[4] UMF Carol Davila, Dept Cardiol, Inst Emergency Cardiovasc Dis, Bucharest, Romania
来源
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS | 2011年 / 79卷 / 05期
关键词
Radiotherapy; Strain rate imaging; Myocardial function; Breast cancer; Cardiotoxicity; CONCURRENT TRASTUZUMAB; HEART-DISEASE; RADIOTHERAPY; MORTALITY; THERAPY; DOXORUBICIN; SURVIVORS;
D O I
10.1016/j.ijrobp.2010.01.004
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: To investigate the occurrence of early radiation-induced changes in regional cardiac function using strain rate imaging (SRI) by tissue Doppler echocardiography. Methods and Materials: We included 20 left-sided and 10 right-sided breast cancer patients receiving radiotherapy (RT) to the breast or chest wall. Standard echocardiography and SRI were performed before RT (baseline), immediately after RT (post-RT), and at 2 months follow-up (FUP) after RT. Regional strain (S) and strain rate (SR) values were obtained from all 18 left ventricular (LV) segments. Data were compared to the regional radiation dose. Results: A reduction in S was observed post-RT and at FUP in left-sided patients (Spost-RT: -17.6 +/- 1.5%, and S-FUP: -17.4 +/- 2.3%, vs. S-baseline:-19.5 +/- 2.1%, p < 0.001) but not in right-sided patients. Within the left-sided patient group, S and SR were significantly reduced after RT in apical LV segments (Spost-RT: -15.3 +/- 2.5%, and S-FUP: -14.3 3.7%, vs. S-baseline: -19.3 +/- 3.0%, p < 0.01; and SRpost-RT: -1.06 +/- 0.15 s(-1), and SRFUP: -1.16 +/- 0.28 s(-1), vs. SRbaseline: 1.29 +/- 0.27 s(-1), p = 0.01), but not in mid- or basal segments. Furthermore, we observed that segments exposed to more than 3 Gy showed a significant decrease in S after RT (Spost-RT: -16.1 +/- 1.6%, and SFUP: -15.8 +/- 3.4%, vs. S-baseline: -18.9 +/- 2.6%, p < 0.001). This could not be observed in segments receiving less than 3 Gy. Conclusions: SRI shows a dose-related regional decrease in myocardial function after RT. It might be a useful tool in the evaluation of modern RT techniques, with respect to cardiac toxicity. (C) 2011 Elsevier Inc.
引用
收藏
页码:1444 / 1451
页数:8
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