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Myocardial perfusion changes in patients irradiated for left-sided breast cancer and correlation with coronary artery distribution.

Publication ,  Journal Article
Lind, PA; Pagnanelli, R; Marks, LB; Borges-Neto, S; Hu, C; Zhou, SM; Light, K; Hardenbergh, PH
Published in: Int J Radiat Oncol Biol Phys
March 15, 2003

PURPOSE: To evaluate postradiation regional heart perfusion changes with single photon emission tomography (SPECT) myocardial perfusion imaging in 69 patients treated with tangential photon beams radiation therapy (RT) for left-sided breast cancer. To correlate SPECT changes with percent irradiated left ventricle (LV) volume and risk factors for coronary artery disease (CAD). METHODS AND MATERIALS: Rest SPECT of the LV was acquired pre-RT and at 6-month intervals post-RT. The extent of defects (%) with a severity > 1.5 standard deviations below the mean was quantitatively analyzed for the distributions of the left anterior descending (LAD) artery, left circumflex (LCX) artery, and right coronary artery (RCA) based on computer assisted polar map reconstruction (i.e., bull's-eye-view). Changes in perfusion were correlated with percent irradiated LV receiving > 25 Gy (range 0-32%). Data on patient- and treatment-related factors were collected prospectively (e.g., cardiac premorbidity, risk factors for CAD, chemotherapy, and hormonal treatment). RESULTS: In the LAD distribution, there were increased perfusion defects at 6 months (median 11%; interquartile range 2-23) compared with baseline (median 5%; interquartile range 1-14) (p < 0.001). There were no increases in perfusion defects in the LCX or RCA distributions. In multivariate analysis, the SPECT perfusion changes in the LAD distribution at 6 months were independently associated with percent irradiated LV (p < 0.001), hormonal therapy (p = 0.005), and pre-RT hypercholesterolemia (p = 0.006). The SPECT defects in the LAD distribution at 12 and 18 months were not statistically different from those at 6 months. The perfusion defects in the LAD distribution were limited essentially to the regions of irradiated myocardium. CONCLUSION: Tangential photon beam RT in patients with left-sided breast cancer was associated with short-term SPECT defects in the vascular distribution corresponding to the radiation portals. Factors related to the extent of perfusion defects included the percent irradiated LV, hormonal treatment, and pre-RT hypercholesterolemia.

Duke Scholars

Published In

Int J Radiat Oncol Biol Phys

DOI

ISSN

0360-3016

Publication Date

March 15, 2003

Volume

55

Issue

4

Start / End Page

914 / 920

Location

United States

Related Subject Headings

  • Ventricular Function, Left
  • Tomography, Emission-Computed, Single-Photon
  • Radiotherapy, Conformal
  • Radiotherapy Dosage
  • Prospective Studies
  • Oncology & Carcinogenesis
  • Middle Aged
  • Mastectomy, Segmental
  • Male
  • Humans
 

Citation

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ICMJE
MLA
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Lind, P. A., Pagnanelli, R., Marks, L. B., Borges-Neto, S., Hu, C., Zhou, S. M., … Hardenbergh, P. H. (2003). Myocardial perfusion changes in patients irradiated for left-sided breast cancer and correlation with coronary artery distribution. Int J Radiat Oncol Biol Phys, 55(4), 914–920. https://doi.org/10.1016/s0360-3016(02)04156-1
Lind, Pehr A., Robert Pagnanelli, Lawrence B. Marks, Salvador Borges-Neto, Caroline Hu, Su Min Zhou, Kim Light, and Patricia H. Hardenbergh. “Myocardial perfusion changes in patients irradiated for left-sided breast cancer and correlation with coronary artery distribution.Int J Radiat Oncol Biol Phys 55, no. 4 (March 15, 2003): 914–20. https://doi.org/10.1016/s0360-3016(02)04156-1.
Lind PA, Pagnanelli R, Marks LB, Borges-Neto S, Hu C, Zhou SM, et al. Myocardial perfusion changes in patients irradiated for left-sided breast cancer and correlation with coronary artery distribution. Int J Radiat Oncol Biol Phys. 2003 Mar 15;55(4):914–20.
Lind, Pehr A., et al. “Myocardial perfusion changes in patients irradiated for left-sided breast cancer and correlation with coronary artery distribution.Int J Radiat Oncol Biol Phys, vol. 55, no. 4, Mar. 2003, pp. 914–20. Pubmed, doi:10.1016/s0360-3016(02)04156-1.
Lind PA, Pagnanelli R, Marks LB, Borges-Neto S, Hu C, Zhou SM, Light K, Hardenbergh PH. Myocardial perfusion changes in patients irradiated for left-sided breast cancer and correlation with coronary artery distribution. Int J Radiat Oncol Biol Phys. 2003 Mar 15;55(4):914–920.
Journal cover image

Published In

Int J Radiat Oncol Biol Phys

DOI

ISSN

0360-3016

Publication Date

March 15, 2003

Volume

55

Issue

4

Start / End Page

914 / 920

Location

United States

Related Subject Headings

  • Ventricular Function, Left
  • Tomography, Emission-Computed, Single-Photon
  • Radiotherapy, Conformal
  • Radiotherapy Dosage
  • Prospective Studies
  • Oncology & Carcinogenesis
  • Middle Aged
  • Mastectomy, Segmental
  • Male
  • Humans