Key result
Proton beam therapy resulted in a 13% incidence of CIED malfunctions compared to 0% for carbon ion therapy, a difference that did not reach statistical significance (p=0.105).
Why the study?
The study was conducted to evaluate the outcomes of particle therapy in cancer patients with cardiac implantable electronic devices.
Does carbon ion therapy reduce CIED malfunctions compared to proton beam therapy in cancer patients with CIEDs?
Cohort (n=69)
Yes
Does carbon ion therapy reduce CIED malfunctions compared to proton beam therapy in cancer patients with CIEDs?
Answers are grounded in this paper and cite their sources.
Passive scattering particle beam therapy caused transient CIED malfunctions (mostly electrical resets) in 13% of proton beam treatments but none in carbon ion treatments, though the difference was not statistically significant.
PURPOSE: To evaluate the outcomes of particle therapy in cancer patients with cardiac implantable electronic devices (CIEDs). MATERIALS AND METHODS: From April 2001 to March 2013, 19,585 patients were treated with proton beam therapy (PBT) or carbon ion therapy (CIT) at 8 institutions. Of these, 69 patients (0.4%, PBT 46, CIT 22, and PBT + CIT 1) with CIEDs (64 pacemakers, 4 implantable cardioverter defibrillators, and 1 with a cardiac resynchronization therapy defibrillator) were retrospectively reviewed. All the patients with CIEDs in this study were treated with the passive scattering type of particle beam therapy. RESULTS: Six (13%) of the 47 PBT patients, and none of the 23 CIT patients experienced CIED malfunctions (p = 0.105). Electrical resets (7) and over-sensing (3) occurred transiently in 6 patients. The distance between the edge of the irradiation field and the CIED was not associated with the incidence of malfunctions in 20 patients with lung cancer. A larger field size had a higher event rate but the test to evaluate trends as not statistically significant (p = 0.196). CONCLUSION: Differences in the frequency of occurrence of device malfunctions for patients treated with PBT and patients treated with CIT did not reach statistical significance. The present study can be regarded as a benchmark study about the incidence of malfunctioning of CIED in passive scattering particle beam therapy and can be used as a reference for active scanning particle beam therapy.
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Hashimoto et al. (2021) conducted a cohort in Cancer with cardiac implantable electronic devices (CIEDs) (n=69). Proton beam therapy vs. Carbon ion therapy was evaluated on CIED malfunctions (Proportion difference 0.128, 95% CI -0.022-0.227, p=0.105). Proton beam therapy resulted in a 13% incidence of CIED malfunctions compared to 0% for carbon ion therapy, a difference that did not reach statistical significance (p=0.105).
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