Heart volume reduction during radiotherapy involving the thoracic region in children: An unexplained phenomenon.
Radiother Oncol
; 128(2): 214-220, 2018 08.
Article
em En
| MEDLINE
| ID: mdl-29703501
ABSTRACT
BACKGROUND AND PURPOSE:
Radiotherapy involving the thoracic region is associated with cardiotoxicity in long-term childhood cancer survivors. We quantified heart volume changes during radiotherapy in children (<18â¯years) and investigated correlations with patient and treatment related characteristics. MATERIAL ANDMETHODS:
Between 2010 and 2016, 34 children received radiotherapy involving the thoracic region. We delineated heart contours and measured heart volumes on 114 CBCTs. Relative volume changes were quantified with respect to the volume on the first CBCT (i.e., 100%). Cardiac radiation dose parameters expressed as 2â¯Gy/fraction equivalent doses were calculated from DVHs. Chemotherapy was categorized as treatment with anthracyclines, alkylating agents, vinca-alkaloids, and other.RESULTS:
The overall median heart volume reduction from the first to the last CBCT was 5.5% (interquartile range1.6-9.7%; pâ¯<â¯0.001). Heart volumes decreased significantly between the baseline measurement and the first week (Bonferroni's adjusted pâ¯=â¯0.002); volume changes were not significant during the following weeks. Univariate analysis showed a significant correlation between heart volume reduction and alkylating agents; however, no multivariate analyses could be done to further confirm this.CONCLUSIONS:
We found a significant heart volume reduction in children during radiotherapy. Elucidation of underlying mechanisms, clinical relevance, and possible long-term consequences of early heart volume reduction require a prospective follow-up study.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Volume Cardíaco
/
Neoplasias
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adolescent
/
Child
/
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
/
Newborn
Idioma:
En
Revista:
Radiother Oncol
Ano de publicação:
2018
Tipo de documento:
Article