Radiation Therapy in Patients with Implanted Cardiac Pacemakers and Implantable Cardioverter Defibrillators: A Prospective Survey in Japan
Radiation Therapy in Patients with Implanted Cardiac Pacemakers and Implantable Cardioverter Defibrillators: A Prospective Survey in Japan
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DOI：
10.1269/jrr.10143
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发表时间：
2011-07-01
影响因子：
2
通讯作者：
Norihisa, Yoshiki
中科院分区：
文献类型：
--
作者：
Soejima, Toshinori;Yoden, Eisaku;Norihisa, Yoshiki
植入式心脏起搏器（ICPs）或植入式心律转复除颤器（ICDs）患者的数量正在增加，对这些患者进行放射治疗的发生率也在增加。因此，对使用这些装置接受放射治疗的患者进行了前瞻性调查。对接受放射治疗的ICP或ICD患者进行前瞻性调查，内容包括放射治疗方法、ICP/ICD状况以及放射治疗前、治疗中、治疗后患者的管理。在完成放射治疗后，研究参与者通过邮件、传真或电子邮件进行登记。在2006年9月至2008年12月期间，来自29家机构的62名病人登记。60例患者有ICP， 2例有ICD。26例（42%）患者在放射治疗前通过剂量-体积直方图估计总剂量，9例（15%）患者通过测量实际剂量估计总剂量。1例患者最大总剂量为2069 cGy；然而，在其他患者中，ICP/ICD剂量不超过478 cGy。38例（61%）放射治疗前检查ICPs和icd功能，32例（52%）放射治疗后检查ICPs和icd功能，29例（47%）放射治疗前后检查ICPs和icd功能。ICP功能障碍发生在前列腺癌患者接受调强放射治疗的前列腺。即使ICP或ICD不在辐射范围内，设备仍可能发生故障。为了尽量减少对患者的风险，在计划和实施放射治疗期间必须采取预防措施。
Patients with implanted cardiac pacemakers (ICPs) or implantable cardioverter defibrillators (ICDs) are increasing in number, and the incidence of treating these patients with radiation therapy also is increasing. Thus, a prospective survey was conducted of patients with these devices receiving radiation therapy. A prospective survey of patients with ICPs or ICDs treated with radiation therapy was conducted on methods of radiation therapy, status of ICP/ICD, and management of patients before, during, and after radiation therapy. After completion of radiation therapy, study participants were registered via mail, fax, or e-mail. Sixty-two patients from 29 institutions were registered from September 2006 to December 2008. Sixty patients had an ICP and 2 had an ICD. The total dose was estimated before radiation therapy by dose-volume histogram in 26 patients (42%) and by measurement of actual doses in 9 (15%). In one patient, the maximum total dose was 2069 cGy; however, in the other patients, the ICP/ICD dose did not exceed 478 cGy. Function of ICPs and ICDs was checked before radiation therapy in 38 patients (61%), after radiation therapy in 32 (52%), and both before and after radiation therapy in 29 (47%). ICP malfunction occurred in a patient with prostate cancer treated by intensity-modulated radiation therapy to the prostate. Even when an ICP or ICD is not within the field of radiation, malfunction of the device may still occur. To minimize the risk to patients, precautions must be taken during the planning and administration of radiation therapy.