在患有食道癌的患者放射治疗期间心脏体积减少
Kenji Makita1,2, Yasushi Hamamoto1, Hiromitsu Kanzaki1
1Department of Radiation Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Ehime 791-0280, Japan.
Molecular and clinical oncology
|February 9, 2024
概括
食道癌放射治疗期间心脏体积减少与下静脉腔体积变化和BMI损失有关,这表明脱水,而不是心脏损伤,是原因. 显著减少可能会转移心脏,冒着过量服用LADR的风险.
科学领域:
- 辐射瘤学 辐射瘤学
- 心血管成像 - 心血管成像
- 医学物理 医学物理
背景情况:
- 食道癌放射治疗可以导致心脏体积减少 (CVR).
- 了解CVR因素对于优化治疗和最大限度地减少心脏毒性至关重要.
- 之前的研究还没有明确确定放射治疗期间CVR的主要驱动因素.
研究的目的:
- 为了调查与心脏体积减小 (CVR) 相关的因素,在接受食道癌 (EC) 放射治疗的患者中.
- 确定CVR与下静脉 (IVC) 体积,体重指数 (BMI) 和其他临床参数的变化之间的关系.
- 评估显著的CVR对辐射剂量对关键心脏结构,如左前垂下冠状动脉区域 (LADR) 的潜在影响.
主要方法:
- 在2016年1月至2022年1月期间接受治疗的58名EC患者的回顾性分析.
- 基于计划CT图像 (初始和离线增强) 的心脏划线.
- 单变量和多重回归分析以确定与CVR的显著关联.
主要成果:
- 在RT期间的CVR与下静脉腔体积 (IVC) 和身体质量指数 (BMI) 损失的变化有显著关联.
- 在CVR>10%的多变量分析中,只有IVC体积变化仍然显著.
- 没有发现CVR和心脏剂量-体积参数,实验室数据或生命体征变化之间的关联.
- 在CVR>10%的病例中,LADR中位移动为1.35厘米,表明潜在的辐射过量.
结论:
- 在EC放射治疗期间的CVR主要与IVC体积的变化有关,这表明脱水是关键因素.
- 辐射诱导的心脏损伤不太可能是心血管复发的主要原因.
- 显著的CVR (>10%) 可能导致LADR大幅移动,增加对这一关键冠状动脉区域过量辐射的风险.
相关概念视频
Radiological Investigation III: Pulmonary Angiogram and PET Scan
92
Radiological investigations are paramount in the diagnosis and management of various pulmonary diseases. Two essential investigations are the Pulmonary Angiogram and the Positron Emission Tomography (PET) Scan.
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...
92
Imaging Studies for Cardiovascular System I:Echocardiography
331
Cardiac imaging studies encompass a wide range of noninvasive and minimally invasive techniques designed to visualize the heart's structure and function in detail. One such technique is echocardiography, which uses high-frequency ultrasound waves to produce detailed images of the heart, known as echocardiograms.
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion,...
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion,...
331
Imaging Studies for Cardiovascular System III: X-Ray
188
The most common cardiovascular diagnostic test is an X-ray. It produces images of the heart, blood vessels, and adjacent structures.
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
188
Exercise and Cardiac Output
1.0K
Regular physical activity is essential for maintaining cardiovascular health, with aerobic exercises being particularly effective. According to the American Heart Association, 150 minutes of moderate to intense aerobic exercise per week is recommended for a healthy heart. Aerobic activities may include brisk walking, running, bicycling, cross-country skiing, and swimming, ideally performed three to five times per week.
Sustained exercise increases the muscles' oxygen demand, which can be...
Sustained exercise increases the muscles' oxygen demand, which can be...
1.0K
Regulation of Stroke Volume
3.2K
The regulation of stroke volume, which is the amount of blood the heart pumps out during each heartbeat, is critical for maintaining a healthy circulatory system. Stroke volume is influenced by three main factors: preload, contractility, and afterload.
Preload refers to the degree of stretch on the heart before it contracts. It's analogous to the stretching of a rubber band; the more it's stretched, the more forcefully it snaps back. This concept is encapsulated in the Frank-Starling law of the...
Preload refers to the degree of stretch on the heart before it contracts. It's analogous to the stretching of a rubber band; the more it's stretched, the more forcefully it snaps back. This concept is encapsulated in the Frank-Starling law of the...
3.2K
Barrett Esophagus-II: Clinical Manifestations and Management
154
Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
154


