Key result
Emergent palliative cardiac radiotherapy rapidly improved dyspnea, liver function, and urine output in a patient with life-threatening cardiac metastasis from small cell lung cancer.
Case Report (n=1)
Palliative cardiac radiotherapy may be an effective alternative treatment for radiosensitive malignancy with cardiac metastasis causing severe heart failure when other treatments are contraindicated.
May support palliative radiotherapy in refractory cardiac metastasis; hypothesis-generating and requires prospective validation.
Cardiac radiotherapy is rarely used in clinical practice because of concern of adverse effects on the heart. We present a case of a 64-year-old man with advanced small cell lung cancer (SCLC) treated with chemo-radiotherapy who attained partial remission initially but had disease progression to bulky cardiac metastasis and significant pericardial effusion. Severe heart failure with hepatic failure was found. Chemotherapy and pericardiocentesis were contraindicated because of the associated high risk and bleeding tendency. Emergent palliative cardiac radiotherapy resulted in rapid improvements of dyspnea, liver function, and urine output. Pericardiocentesis was performed 5 days later and effusion cytology confirmed metastatic SCLC. To our knowledge, this is the first case of effective cardiac radiotherapy for SCLC with life-threatening cardiac metastasis. Palliative cardiac radiotherapy may be an effective alternative treatment for radiosensitive malignancy with cardiac metastasis in cases of multiple organ dysfunction and unsuitability for chemotherapy and pericardiocentesis.
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Chen et al. (2018) conducted a case report in Advanced small cell lung cancer with cardiac metastasis and severe heart failure (n=1). Palliative cardiac radiotherapy was evaluated on Clinical improvement (dyspnea, liver function, urine output). Emergent palliative cardiac radiotherapy rapidly improved dyspnea, liver function, and urine output in a patient with life-threatening cardiac metastasis from small cell lung cancer.
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