Romanowska Anna, Lewicka Ewa, Sławiński Grzegorz, Jankowska Hanna, Zaucha Renata
Department of Oncology and Radiotherapy, University Clinical Centre, Gdańsk, Poland.
Department of Cardiology and Electrotherapy, Medical University of Gdańsk, Gdańsk, Poland.
Front Oncol. 2021 Feb 26;11:621289. doi: 10.3389/fonc.2021.621289. eCollection 2021.
Intimal sarcoma of the heart is a sporadic disease, which involves symptoms of cardiac insufficiency due to a fast-growing intraluminal mass. Tumor resection is the first-line treatment, although its location precludes excision with wide uninvolved margins. Despite the aggressiveness of this neoplasm and a high risk of recurrence even after removal by microscopically radical surgery, no standard adjuvant therapy has been established. Chemotherapy is used either as an adjuvant treatment or in cases of advanced disease. In contrast, the use of radiotherapy is rare and usually considered in a palliative setting because the risk of radiation-induced heart disease after high-dose radiotherapy to the heart is significant. Herein, we present the cases of two patients, both diagnosed with cardiac intimal sarcoma, who received irradiation after tumor resection. In both cases, radiotherapy was effective, providing long-lasting local disease control. We regularly monitored cardiac function in both patients to assess the impact of radiotherapy on tumor-free heart structures. The excellent local control of the disease with only mild long-term cardiac dysfunction in both patients suggests that radiotherapy can be a useful treatment modality in this indication.
心脏内膜肉瘤是一种散发性疾病，由于管腔内肿块快速生长而出现心脏功能不全症状。肿瘤切除是一线治疗方法，尽管其位置使得无法在切缘无肿瘤累及的情况下进行广泛切除。尽管这种肿瘤具有侵袭性，甚至在显微镜下根治性手术后复发风险也很高，但尚未确立标准的辅助治疗方法。化疗可作为辅助治疗或用于晚期疾病。相比之下，放疗的应用很少，通常在姑息治疗中考虑，因为对心脏进行高剂量放疗后发生放射性心脏病的风险很大。在此，我们报告了两名均被诊断为心脏内膜肉瘤的患者在肿瘤切除后接受放疗的病例。在这两个病例中，放疗均有效，实现了持久的局部疾病控制。我们定期监测两名患者的心脏功能，以评估放疗对无肿瘤心脏结构的影响。两名患者均实现了疾病的良好局部控制，且仅有轻度的长期心脏功能障碍，这表明放疗在该适应症中可能是一种有用的治疗方式。
