Key result
Emergency radiotherapy achieves rapid symptom relief and ~90% SUVmax reduction in a cardiac lymphoma case.
Why the study?
Primary cardiac lymphoma is rare and aggressive, and critically ill patients often present with contraindications to first-line chemotherapy.
Does emergency radiotherapy improve symptoms and metabolic response in a critically ill patient with primary cardiac lymphoma who is ineligible for immediate chemotherapy?
Case Report (n=1)
No
Does emergency radiotherapy improve symptoms and metabolic response in a critically ill patient with primary cardiac lymphoma who is ineligible for immediate chemotherapy?
Answers are grounded in this paper and cite their sources.
Emergency ultra-hypofractionated radiotherapy can serve as an effective and rapid bridge to systemic chemotherapy in critically ill patients with primary cardiac lymphoma.
Primary cardiac lymphoma (PCL), an exceptionally rare and aggressive malignancy with median survival under one month, often presents with contraindications to first-line chemotherapy in critically ill patients. We report a 66-year-old woman with acute heart failure, pulmonary embolism, and ECOG performance status 4, diagnosed with right atrial diffuse large B-cell lymphoma (76 × 75 mm, SUVmax = 29.1). Due to chemotherapy contraindications, emergency radiotherapy (18 Gy/10 fractions) was initiated. Within five fractions, significant symptomatic improvement occurred with resolution of dyspnea and edema, accompanied by improved oxygenation (SpO₂ 86%→95%) and ECOG status (4→3). Post-treatment PET/CT demonstrated a profound metabolic response (SUVmax = 2.9–3.6), enabling successful transition to systemic chemotherapy. This case underscores emergency radiotherapy as an effective bridge therapy for critically ill PCL patients, facilitated by multidisciplinary coordination.
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Yu et al. (2026) conducted a case report in Primary cardiac lymphoma (n=1). Emergency radiotherapy (VMAT) was evaluated on Symptomatic and metabolic response. Emergency radiotherapy achieved rapid symptomatic relief and profound metabolic response (SUVmax reduction from 29.1 to 2.9-3.6) in a critically ill patient with primary cardiac lymphoma.
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