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Poor outcome in radiation-induced constrictive pericarditis

T Karram1, D Rinkevitch, W Markiewicz

  • 1Department of Cardiology, Rambam Medical Center, Technion Medical School, Haifa, Israel.

International Journal of Radiation Oncology, Biology, Physics
|January 15, 1993
PubMed
Summary

Patients with radiation-induced constrictive pericarditis have a significantly poorer prognosis compared to other causes. This study highlights the multifactorial reasons for poor surgical outcomes in radiation-induced cases.

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Area of Science:

  • Cardiology
  • Thoracic Surgery
  • Oncology

Background:

  • Constrictive pericarditis can arise from various etiologies, including radiation therapy.
  • Radiation-induced pericarditis presents unique challenges in patient management and outcomes.

Purpose of the Study:

  • To compare the clinical outcomes of patients with radiation-induced constrictive pericarditis against those with constrictive pericarditis from other causes.

Main Methods:

  • A retrospective analysis of 20 patients with constrictive pericarditis was conducted.
  • Six patients had radiation-induced constrictive pericarditis (Group A), and 14 had other etiologies (Group B).
  • Surgical intervention (pericardiectomy) was performed in a subset of patients from both groups.

Main Results:

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  • All six patients in Group A (radiation-induced) died within 11 years post-diagnosis, with a median survival of 10 months.
  • Causes of death in Group A included sudden death, post-operative respiratory failure, pneumonia, and recurrent carcinoma.
  • In contrast, 13 out of 14 patients in Group B (other etiologies) survived with a median follow-up of 72 months, with the single death attributed to metastatic cancer.

Conclusions:

  • Radiation-induced constrictive pericarditis is associated with a significantly worse prognosis.
  • Factors contributing to poor outcomes include recurrent tumor, high-dose irradiation, pulmonary fibrosis, and radiation-induced damage to cardiac structures.