Treatment Related Cardiac Toxicity in Patients Treated for Breast Cancer

摘要

Purpose: To determine the incidence dose/time-dependence and functional significance of regional cardiac perfusion abnormalities in patients with left-sided breast cancer treated with radiation therapy (RT) with and without doxorubicin. Methods: 160 patients underwent pre-RT single photon emission computed tomography (SPECT) cardiac perfusion imaging. Post-RT images were obtained in 125, 95, 56, 43, 24, 28, 21 and 2 patients at 6, 12, 18, 24 36, 48, 60 and 72 months post-RT. SPECT perfusion images were registered onto 3-dimensional (3D) RT dose distributions. The volume of heart in the RT field was quantified and the regional RT dose was calculated. Changes in regional and global cardiac function were assessed. Results: The incidence of new perfusion defects 6 12 16 24 36 46 and 60 months post RT was 38% 35% 38% 42% 52% 71% and 67% respectively. In the 44 patients who have longer follow-up beyond 2 years 30/44 68%0 exhibit perfusion defects. New defects occurred in approximately 0-80% and 30-80% of patients with.