WE-G-218-03: Management of RT Patients with Implanted Cardiac Devices: From Recommendation to Practical...

Area of Science:

• Medical Physics
• Cardiology
• Radiation Oncology

Background:

• Current guidelines for managing patients with pacemakers (ICPs) or defibrillators (ICDs) undergoing radiotherapy are outdated due to technological advancements.
• Clinical practices vary, and the number of patients with CIEDs referred for radiation therapy is increasing, necessitating updated guidance.

Purpose of the Study:

• To address the need for updated guidelines for managing patients with cardiac implantable electronic devices (CIEDs) undergoing radiation therapy.
• To focus on management aspects, including decision-making questions, risk assessment, and practical measures.
• To facilitate a multidisciplinary approach involving patients, cardiologists, and radiation oncology departments.

Main Methods:

• Literature review and analysis of existing recommendations and dose measurement methods.
• Focus on clinical management questions for radiotherapy in CIED patients.
• Development of risk classifications based on CIED failure probability and patient consequences.

Main Results:

• Identified key questions for determining radiotherapy eligibility in CIED patients.
• Emphasized the importance of communication between cardiology and radiation oncology.
• Proposed risk stratification distinguishing between pacing-dependent and independent patients.

Conclusions:

• Updated guidelines are essential for the safe and effective management of CIED patients undergoing radiation therapy.
• A multidisciplinary, risk-stratified approach is recommended.
• New guidelines, such as the Dutch national guideline, offer a framework for practice.