Symptomatic cardiac events following radiation therapy for left-sided breast cancer: Possible association with radiation therapy-induced changes in regional perfusion

Xiaoli Yu, Robert R. Prosnitz, Sumin Zhou, Patricia H. Hardenbergh, Andrea Tisch, Michael A. Blazing, Salvador Borges-Neto, Donna Hollis, Terence Wong, Lawrence B. Marks

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

Our group has demonstrated that tangential radiation therapy (RT) to the left breast or chest wall can cause perfusion changes the anterior myocardium. We assess if RT-induced perfusion changes are associated with the development of symptoms consistent with cardiac dysfunction. Between 1998 and 2001, 114 patients were enrolled into an institutional review board-approved prospective study and had pre-RT and serial post-RT (range, 6-24 months) single photon emission computed tomography (SPECT) scans to assess changes in regional cardiac perfusion. Thirty-one patients were excluded. The incidence of cardiac symptoms in patients with and without RT-induced perfusion defects was compared using a 2-tailed Fisher's exact test. With a median follow-up of 16 months (range, 6-24 months), 10 of 83 evaluable patients had ≥ 1 episode of transient chest pain, occurring 0-14 months after RT (median, 6 months). The rates of chest pain in the patients with and without new perfusion defects were 9 of 31 and 1 of 52, respectively (P = 0.0004). A similar result was found when patients were segregated based on the use of chemotherapy. Two of these 10 cases were diagnosed as pericarditis. No patient had myocardial infarction or congestive heart failure. Cardiac symptoms occur more frequently in patients with perfusion abnormalities by SPECT after RT than in patients with normal SPECT scans, suggesting that such perfusion defects may be clinically significant. One confounding factor is that women who know they have RT-induced perfusion defects may be more likely to report episode of chest pain. Long-term follow-up will be necessary to better assess the clinical significance of RT-induced perfusion defects.

Original languageEnglish (US)
Pages (from-to)193-197
Number of pages5
JournalClinical Breast Cancer
Volume4
Issue number3
StatePublished - Aug 2003

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Radiotherapy
Perfusion
Single-Photon Emission-Computed Tomography
Chest Pain
Unilateral Breast Neoplasms
Pericarditis
Research Ethics Committees
Thoracic Wall
Myocardium
Breast
Heart Failure
Myocardial Infarction
Prospective Studies
Drug Therapy
Incidence

Keywords

  • Chest pain
  • Heart effect
  • Myocardial perfusion
  • Perfusion defects
  • SPECT

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Symptomatic cardiac events following radiation therapy for left-sided breast cancer : Possible association with radiation therapy-induced changes in regional perfusion. / Yu, Xiaoli; Prosnitz, Robert R.; Zhou, Sumin; Hardenbergh, Patricia H.; Tisch, Andrea; Blazing, Michael A.; Borges-Neto, Salvador; Hollis, Donna; Wong, Terence; Marks, Lawrence B.

In: Clinical Breast Cancer, Vol. 4, No. 3, 08.2003, p. 193-197.

Research output: Contribution to journalArticle

Yu, X, Prosnitz, RR, Zhou, S, Hardenbergh, PH, Tisch, A, Blazing, MA, Borges-Neto, S, Hollis, D, Wong, T & Marks, LB 2003, 'Symptomatic cardiac events following radiation therapy for left-sided breast cancer: Possible association with radiation therapy-induced changes in regional perfusion', Clinical Breast Cancer, vol. 4, no. 3, pp. 193-197.
Yu, Xiaoli ; Prosnitz, Robert R. ; Zhou, Sumin ; Hardenbergh, Patricia H. ; Tisch, Andrea ; Blazing, Michael A. ; Borges-Neto, Salvador ; Hollis, Donna ; Wong, Terence ; Marks, Lawrence B. / Symptomatic cardiac events following radiation therapy for left-sided breast cancer : Possible association with radiation therapy-induced changes in regional perfusion. In: Clinical Breast Cancer. 2003 ; Vol. 4, No. 3. pp. 193-197.
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