质子束治疗对植入式心脏起搏器的干扰。
Proton beam therapy interference with implanted cardiac pacemakers.
作者信息
Oshiro Yoshiko, Sugahara Shinji, Noma Mio, Sato Masato, Sakakibara Yuzuru, Sakae Takeji, Hayashi Yasutaka, Nakayama Hidetsugu, Tsuboi Koji, Fukumitsu Nobuyoshi, Kanemoto Ayae, Hashimoto Takayuki, Tokuuye Koichi
机构信息
Department of Radiation Oncology, University of Tsukuba, Ibaraki, Japan.
出版信息
Int J Radiat Oncol Biol Phys. 2008 Nov 1;72(3):723-7. doi: 10.1016/j.ijrobp.2008.01.062. Epub 2008 Jun 4.
PURPOSE
To investigate the effect of proton beam therapy (PBT) on implanted cardiac pacemaker function.
METHODS AND MATERIALS
After a phantom study confirmed the safety of PBT in patients with cardiac pacemakers, we treated 8 patients with implanted pacemakers using PBT to a total tumor dose of 33-77 gray equivalents (GyE) in dose fractions of 2.2-6.6 GyE. The combined total number of PBT sessions was 127. Although all pulse generators remained outside the treatment field, 4 patients had pacing leads in the radiation field. All patients were monitored by means of electrocardiogram during treatment, and pacemakers were routinely examined before and after PBT.
RESULTS
The phantom study showed no effect of neutron scatter on pacemaker generators. In the study, changes in heart rate occurred three times (2.4%) in 2 patients. However, these patients remained completely asymptomatic throughout the PBT course.
CONCLUSIONS
PBT can result in pacemaker malfunctions that manifest as changes in pulse rate and pulse patterns. Therefore, patients with cardiac pacemakers should be monitored by means of electrocardiogram during PBT.
目的
研究质子束治疗（PBT）对植入式心脏起搏器功能的影响。
方法与材料
在模型研究证实PBT对心脏起搏器患者的安全性后，我们对8例植入起搏器的患者进行了PBT治疗，总肿瘤剂量为33 - 77格雷当量（GyE），分剂量为2.2 - 6.6 GyE。PBT治疗总次数为127次。虽然所有脉冲发生器均位于治疗野之外，但有4例患者的起搏导线位于辐射野内。治疗期间所有患者均通过心电图进行监测，并且在PBT治疗前后对起搏器进行常规检查。
结果
模型研究表明中子散射对起搏器发生器无影响。在该研究中，2例患者心率出现三次变化（2.4%）。然而，这些患者在整个PBT治疗过程中均完全无症状。
结论
PBT可导致起搏器功能故障，表现为脉搏率和脉搏模式的变化。因此，心脏起搏器患者在PBT治疗期间应通过心电图进行监测。
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