Students Research Committee, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Department of Medical Physics, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.
J Med Imaging Radiat Sci. 2023 Sep;54(3):495-502. doi: 10.1016/j.jmir.2023.04.004. Epub 2023 May 12.
The primary objective of radiation therapy (RT) is to deliver lethal radiation doses to abnormal cancer cells so that healthy cells are exposed to minimal radiation. In the present study, changes in electrocardiography (ECG) and echocardiography(ECHO) following adjuvant RT were investigated in patients with left-sided breast cancer.
30 patients with left-sided breast cancer who had previously undergone breast-conserving surgery or mastectomy underwent RT after completing chemotherapy from February 2019 to January 2020. ECG and ECHO tests were performed before RT, immediately following RT, and three months after RT. Dose-volume parameters of the heart and its substructures as an organ at risk were analyzed.
The mean heart dose (±SD) for all patients was 7.51 ± 2.42 Gy. T-wave inversion was observed 3 months after RT in 47% of patients. T-wave decline was associated with mean heart radiation dose (β = 0.605, p-value = 0.005). The present study showed that the left ventricular volume receiving the 5 Gy (LV-V) parameter was associated with a reduction in ST segment duration (p-value = 0.027) as well as with an increase in left ventricular systolic diameter (LVESD, mm) (P-value = 0.027).
RT-induced ECG and ECHO changes are frequent in patients with left breast cancer. LVEF and Twave abnormalities were observed after RT in our patients. ECG and ECHO modalities can be used to monitor the cardiac function after RT in patients with left-sided breast cancer.
放射治疗（RT）的主要目标是向异常癌细胞提供致死剂量的辐射，以使健康细胞暴露于最小剂量的辐射。在本研究中，我们研究了左侧乳腺癌患者在接受辅助 RT 后心电图（ECG）和超声心动图（ECHO）的变化。
2019 年 2 月至 2020 年 1 月，30 例接受过保乳手术或乳房切除术的左侧乳腺癌患者在完成化疗后接受 RT。在 RT 前、RT 后即刻和 RT 后 3 个月进行 ECG 和 ECHO 检查。分析心脏及其亚结构作为危险器官的剂量-体积参数。
所有患者的平均心脏剂量（±SD）为 7.51±2.42Gy。47%的患者在 RT 后 3 个月出现 T 波倒置。T 波下降与平均心脏辐射剂量相关（β=0.605，p 值=0.005）。本研究表明，接受 5 Gy 的左心室容积（LV-V）参数与 ST 段持续时间缩短（p 值=0.027）以及左心室收缩直径（LVESD，mm）增加相关（p 值=0.027）。
左侧乳腺癌患者接受 RT 后常出现心电图和 ECHO 变化。我们的患者在 RT 后观察到 LVEF 和 Twave 异常。心电图和超声心动图可用于监测左侧乳腺癌患者 RT 后心脏功能。
