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Radiation-related pericarditis.

R G Martin, J C Ruckdeschel, P Chang

    The American Journal of Cardiology
    |February 1, 1975
    PubMed
    Summary
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    Upper mantle radiation therapy for Hodgkin's disease can cause pericardial effusion in nearly 30% of patients. Most effusions occur within 12 months post-treatment, requiring close monitoring and intervention for cardiac tamponade.

    Area of Science:

    • Cardiology
    • Oncology
    • Radiology

    Background:

    • Upper mantle radiation therapy is a treatment for Hodgkin's disease.
    • Pericardial effusion is a potential complication of radiation therapy.
    • Understanding the incidence and natural history of pericardial effusion is crucial for patient management.

    Purpose of the Study:

    • To determine the incidence of pericardial effusion in patients with Hodgkin's disease undergoing upper mantle radiation therapy.
    • To characterize the timing and clinical course of radiation-induced pericardial effusion.
    • To assess the need for intervention in cases of cardiac tamponade.

    Main Methods:

    • Retrospective analysis of 81 patients with Hodgkin's disease (stages I-IIIB) treated with upper mantle radiation therapy.

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  • X-ray criteria used to identify pericardial effusion.
  • Right heart catheterization performed in 11 patients to confirm effusion and assess hemodynamics.
  • Follow-up to monitor for effusion recurrence and disease progression.

    • Main Results:

    • Twenty-four patients (29.6%) developed pericardial effusion.
    • Ninety-two percent of effusions occurred within 12 months post-radiation.
    • Fourteen patients had transient effusions.
    • Five patients required partial pericardiectomy for cardiac tamponade.
    • No recurrent Hodgkin's disease observed in surgically treated patients.

    Conclusions:

    • Upper mantle radiation therapy is associated with a significant incidence of pericardial effusion in Hodgkin's disease patients.
    • Pericardial effusions typically manifest within the first year after treatment.
    • Close follow-up and surgical intervention for cardiac tamponade are necessary.
    • Further research into the natural history of this complication is warranted.