- 作者：Masamitsu Hatakenaka ; M.D. ; Ph.D.&lowast ; ; ¶ ; ; mhatakenaka@sapmed.ac.jp ; Masato Yonezawa ; M.D.&lowast ; ; Takeshi Nonoshita ; M.D.&lowast ; ; Katsumasa Nakamura ; M.D. ; Ph.D.&lowast ; ; Hidetake Yabuuchi ; M.D. ; Ph.D.&dagger ; ; Yoshiyuki Shioyama ; M.D. ; Ph.D.&lowast ; ; Michinobu Nagao ; M.D. ; Ph.D.&Dagger ; ; Yoshio Matsuo ; M.D. ; Ph.D.&lowast ; ; Takeshi Kamitani ; M.D.&lowast ; ; Taiki Higo ; M.D.§ ; ; Kei Nishikawa ; R.T.?/sup> ; Taro Setoguchi ; M.D.&lowast ; &lowast ; ; Hiroshi Honda ; M.D. ; Ph.D.&lowast ;
- 关键词：Esophageal cancer ; Chemoradiotherapy ; Cardiac function ; Magnetic resonance imaging
- 刊名：International Journal of Radiation Oncology*Biology*Physics
- 出版年：2012
- 出版时间：1 May, 2012
- 年：2012
- 卷：83
- 期：1
- 页码：e67-e73
- 全文大小：687 K
Purpose
To evaluate acute cardiac effects of concurrent chemoradiotherapy (CCRT) for esophageal cancer.Methods and Materials
This prospective study was approved by the institutional review board, and written informed consent was obtained from all participants. The left ventricular function (LVF) of 31 patients with esophageal cancer who received cisplatin and 5-fluorouracil-based CCRT was evaluated using cardiac cine magnetic resonance imaging. The patients were classified into two groups according to mean LV dose. The parameters related to LVF were compared between before and during (40 Gy) or between before and after CCRT using a Wilcoxon matched-pairs single rank test, and parameter ratios (during/before CCRT, after/before CCRT) were also compared between the groups with a t test. Data were expressed as mean ¡À SE.
Results
In the low LV-dose group (n = 10; mean LV dose <0.6 Gy), LV ejection fraction decreased significantly (before vs. during vs. after CCRT; 62.7 % ¡À 2.98 % vs. 59.8 % ¡À 2.56 % vs. 60.6 % ¡À 3.89 % ; p < 0.05). In the high LV-dose group (n = 21; mean LV dose of 3.6-41.2 Gy), LV end-diastolic volume index (before vs. after CCRT; 69.1 ¡À 2.93 vs. 57.0 ¡À 3.23 mL/m2), LV stroke volume index (38.6 ¡À 1.56 vs. 29.9 ¡À 1.60 mL/m2), and LV ejection fraction (56.9 % ¡À 1.79 % vs. 52.8 % ¡À 1.15 % ) decreased significantly (p < 0.05) after CCRT. Heart rate increased significantly (before vs. during vs. after CCRT; 66.8 ¡À 3.05 vs. 72.4 ¡À 4.04 vs. 85.4 ¡À 3.75 beats per minute, p < 0.01). Left ventricle wall motion decreased significantly (p < 0.05) in segments 8 (before vs. during vs. after CCRT; 6.64 ¡À 0.54 vs. 4.78 ¡À 0.43 vs. 4.79 ¡À 0.50 mm), 9 (6.88 ¡À 0.45 vs. 5.04 ¡À 0.38 vs. 5.27 ¡À 0.47 mm), and 10 (9.22 ¡À 0.48 vs. 8.08 ¡À 0.34 vs. 8.19 ¡À 0.56 mm). The parameter ratios of LV end-diastolic volume index, stroke volume index, wall motion in segment 9, and heart rate showed significant difference (p?<?0.05) after CCRT between the groups.
Conclusions
Concurrent chemoradiotherapy for esophageal cancer impairs LVF from an early treatment stage. This impairment is prominent in patients with high LV dose.