Investigation of electrocardiography and echocardiography changes after adjuvant radiation therapy of left-sided breast cancer

Kolsoum Teimouri; Karim Khoshgard; Negin Farshchian; Mohammad Rouzbahani; Javad Azimivaghar

doi:10.1016/j.jmir.2023.04.004

Investigation of electrocardiography and echocardiography changes after adjuvant radiation therapy of left-sided breast cancer

J Med Imaging Radiat Sci. 2023 Sep;54(3):495-502. doi: 10.1016/j.jmir.2023.04.004. Epub 2023 May 12.

Authors

Kolsoum Teimouri¹, Karim Khoshgard², Negin Farshchian³, Mohammad Rouzbahani⁴, Javad Azimivaghar⁴

Affiliations

¹ Students Research Committee, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.
² Department of Medical Physics, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran. Electronic address: khoshgardk@gmail.com.
³ Department of Radiation Oncology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.
⁴ Department of Cardiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.

PMID: 37183077
DOI: 10.1016/j.jmir.2023.04.004

Abstract

Introduction: 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.

Materials and methods: 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.

Results: 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-V₅) 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).

Conclusion: 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.

Keywords: Breast cancer; Echocardiography; Electrocardiography; Radiotherapy.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Breast Neoplasms* / complications
Breast Neoplasms* / diagnostic imaging
Breast Neoplasms* / radiotherapy
Echocardiography
Electrocardiography
Female
Humans
Mastectomy
Radiotherapy, Adjuvant
Unilateral Breast Neoplasms* / diagnostic imaging
Unilateral Breast Neoplasms* / radiotherapy