DEGRO/DGK guideline for radiotherapy in patients with cardiac implantable electronic devices; [Leitlinie der DEGRO/DGK zur Strahlentherapie bei Patienten mit kardialen implantierten elektronischen Geräten]

被引：0

作者：

Gauter-Fleckenstein B. ^{[1
]}

Israel C.W. ^{[2
]}

Dorenkamp M. ^{[3
]}

Dunst J. ^{[4
]}

Roser M. ^{[5
]}

Schimpf R. ^{[6
]}

Steil V. ^{[1
]}

Schäfer J. ^{[7
]}

Höller U. ^{[8
]}

Wenz F. ^{[1
]}

机构：

[1] Klinik für Strahlentherapie und Radioonkologie, Universitätsmedizin Mannheim, Ruprecht-Karls-Universität Heidelberg, Theodor-Kutzer-Ufer 1–3, Mannheim

[2] Klinik für Innere Medizin—Kardiologie, Diabetologie und Nephrologie, Ev. Krankenhaus Bielefeld, Bielefeld

[3] Medizinische Klinik mit Schwerpunkt Kardiologie, Charité—Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin

[4] Klinik für Strahlentherapie, Universitätsklinik Schleswig-Holstein, Campus Lübeck, Lübeck

[5] Medizinische Klinik für Kardiologie und Pulmologie, Charité—Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin

[6] I. Medizinische Klinik—Kardiologie, Universitätsmedizin Mannheim, Ruprecht-Karls-Universität Heidelberg, Heidelberg

[7] Strahlentherapie Speyer, Paul-Egell-Straße 31, Speyer

[8] Klinik für Radioonkologie und Strahlentherapie, Charité Universitätsmedizin Berlin, Campus Charité Mitte, Berlin

来源：

Strahlentherapie und Onkologie | 2015年 / 191卷 / 5期

关键词：

Cardiac implantable electronic devices; Cardiac pacemaker; Implanted cardioverter/defibrillator; Ionizing radiation; Radiation therapy;

D O I：

10.1007/s00066-015-0817-3

中图分类号：

学科分类号：

摘要：

An increasing number of patients undergoing radiotherapy (RT) have cardiac implantable electronic devices [CIEDs, cardiac pacemakers (PMs) and implanted cardioverters/defibrillators (ICDs)]. Ionizing radiation can cause latent and permanent damage to CIEDs, which may result in loss of function in patients with asystole or ventricular fibrillation. Reviewing the current literature, the interdisciplinary German guideline (DEGRO/DGK) was developed reflecting patient risk according to type of CIED, cardiac condition, and estimated radiation dose to the CIED. Planning for RT should consider the CIED specifications as well as patient-related characteristics (pacing-dependent, previous ventricular tachycardia/fibrillation). Antitachyarrhythmia therapy should be suspended in patients with ICDs, who should be under electrocardiographic monitoring with an external defibrillator on stand-by. The beam energy should be limited to 6 (to 10) MV CIEDs should never be located in the beam, and the cumulative scatter radiation dose should be limited to 2 Gy. Personnel must be able to respond adequately in the case of a cardiac emergency and initiate basic life support, while an emergency team capable of advanced life support should be available within 5 min. CIEDs need to be interrogated 1, 3, and 6 months after the last RT due to the risk of latent damage. © 2015, Springer-Verlag Berlin Heidelberg.

引用

页码：393 / 404

页数：11

共 65 条

[1] Berg R.A., Hemphill R., Abella B.S., Et al., Part 5: adult basic life support: 2010 American heart association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care, Circulation, 122, pp. 685-705, (2010)
[2] Strahlentherapie und Biotronik CRM-Implantate – Herzschrittmacher (IPG), Defibrillatoren (ICD) und CRT-Geräte, Berlin: Biotronik SE & Co, (2011)
[3] Blamires N.G., Myatt J., X-ray effects on pacemaker type circuits, Pacing Clin Electrophysiol, 5, pp. 151-155, (1982)
[4] Croshaw R., Kim Y., Lappinen E., Et al., Avoiding mastectomy: accelerated partial breast irradiation for breast cancer patients with pacemakers or defibrillators, Ann Surg Oncol, 18, pp. 3500-3505, (2011)
[5] Dasgupta T., Barani I.J., Roach M., Successful radiation treatment of anaplastic thyroid carcinoma metastatic to the right cardiac atrium and ventricle in a pacemaker-dependent patient, Radiat Oncol, 6, (2011)
[6] Dorenkamp M., Roser M., Hamm B., Et al., Magnetic resonance imaging and implantable cardiac devices. Current status and future perspectives of MR-compatible systems, Herz, 37, pp. 136-145, (2012)
[7] Elders J., Kunze-Busch M., Jan Smeenk R., Et al., High incidence of implantable cardioverter defibrillator malfunctions during radiation therapy: neutrons as a probable cause of soft errors, Europace, 15, pp. 60-65, (2013)
[8] Ferrara T., Baiotto B., Malinverni G., Et al., Irradiation of pacemakers and cardio-defibrillators in patients submitted to radiotherapy: a clinical experience, Tumori, 96, pp. 76-83, (2010)
[9] Franco L., Gomez F., Iglesias A., SEUs on commercial SRAM induced by low energy neutrons produced at a clinical linac facility, RADECS Proceedings, (2005)
[10] Frantz S., Wagner J., Langenfeld H., Radiation-induced pacemaker malfunction, Z Kardiol, 92, pp. 415-417, (2003)

← 1 2 3 4 5 6 7 →