UroToday - Can Prophylactic Breast Irradiation Contribute to Cardiac Toxicity in Patients with Prostate Cancer Receiving Androgen Suppressing Drugs? - abstract

February 5, 2008

reast_irradiation_contribute_to_cardiac_toxicity_in_patients_with_prostate_c

ancer_receiving_androgen_suppressing_drugs__abstract.html

Monday, 04 February 2008

Androgen suppression treatment (AST) might increase the risk of cardiac

morbidity in prostate cancer patients. Possible explanations were provided,

however, they disregard the potential contribution of prophylactic

radiotherapy to the mamillary regions (PMRT, prescribed to avoid

gynecomastia).

We studied the exposure of the heart in a typical electron beam PMRT setting

by evaluating computed tomography (CT) scans in 40 non-cancer patients (age

65 and 75 years in 50% each) and 17 prostate cancer patients. Five of the

younger, 7 of the older and 4 of the cancer patients had significant cardiac

disease.

The median distance between skin and outer heart contour decreased with age.

In all three groups, patients with cardiac morbidity had smaller distances.

When using the CT-determined PMRT beam energy, 10% of the younger, 15% of

the older and none of the prostate cancer patients would receive

approximately 50% of the prescription dose to a part of the heart (2 had no

history of cardiac disease). When using the clinically rather than

CT-determined beam energy, as often done in daily practice, an additional

12.5% of the non-cancer and 12% of the prostate cancer patients would be

exposed to comparably high doses.

The present data provide preliminary evidence that PMRT might be a factor

that contributes to cardiac side effects. Previous studies that established

a relationship between AST and cardiac morbidity did not include information

on delivery of PMRT.

Written by

Nieder C, Pawinski A, Andratschke NH, Molls M.

Reference

Radiat Oncol. 2008 Jan 10

doi:10.1186/1748-717X-3-2

PubMed Abstract

PMID:18186924

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