Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, Japan;
Department of Radiation Oncology, Osaka General Medical Center, Osaka, Japan.
Anticancer Res. 2024 Sep;44(9):4113-4117. doi: 10.21873/anticanres.17240.
BACKGROUND/AIM: Radiotherapy-induced malfunction of pacemakers and cardiac defibrillators has been reported, and corresponding guidelines have been developed in various countries. Although several studies have reported the effects of radiotherapy in patients with implantable left ventricular assist device (LVAD), its safety remains unclear. Herein, we report three cases of stereotactic ablative radiotherapy (SABR) using CyberKnife for early-stage lung cancer in patients with implantable LVAD.
Three patients in their 50s or 60s, including two women and one man, who had LVADs due to dilated or ischemic cardiomyopathy and performance status of 0 or 1, were diagnosed with stage IA2 lung cancer (cT1bN0M0) by imaging only. All three patients were deemed inoperable due to cardiac comorbidity and underwent SABR at the Osaka University Hospital. The total radiation dose was 42-52 Gy, administered in four fractions. All treatment plans were designed to keep the LVAD dose below 2 Gy. In all patients, SABR was completed without acute adverse events or LVAD malfunction. During the follow-up period of 3-29 months, no disease progression or chronic adverse events were observed in any of the patients.
This case series indicated that SABR using CyberKnife is a safe treatment option for early-stage lung cancer in patients with LVAD by reducing the dose to the LVAD.
背景/目的：已报道放射治疗可导致起搏器和心脏除颤器故障，并且各国已制定相应的指南。尽管有几项研究报告了放射治疗对植入式左心室辅助装置（LVAD）患者的影响，但该治疗的安全性仍不清楚。在此，我们报告了 3 例使用 CyberKnife 立体定向消融放疗（SABR）治疗植入式 LVAD 的早期肺癌患者。
3 例患者均为 50 多岁或 60 多岁，其中 2 例为女性，1 例为男性，均因扩张型或缺血性心肌病和 0 或 1 的体能状态而植入 LVAD，通过影像学检查诊断为 IA2 期肺癌（cT1bN0M0）。由于心脏合并症，所有 3 例患者均被认为无法手术，并在大阪大学医院接受 SABR 治疗。总辐射剂量为 42-52Gy，分 4 次给予。所有治疗计划均旨在将 LVAD 剂量控制在 2Gy 以下。在所有患者中，SABR 均顺利完成，无急性不良反应或 LVAD 故障。在 3-29 个月的随访期间，所有患者均未出现疾病进展或慢性不良反应。
该病例系列表明，通过降低 LVAD 剂量，使用 CyberKnife 的 SABR 是 LVAD 患者早期肺癌的一种安全治疗选择。
