Cardiac function, perfusion, and morbidity in irradiated long-term survivors of Hodgkin's disease
Key result
Mantle irradiation in Hodgkin's survivors is linked to generally normal LV function despite slightly lower LVEF.
- P=0.051
- n=50
Why the study?
The incidence of cardiotoxicity and clinical cardiac events following mantle irradiation in Hodgkin's disease patients using modern techniques is controversial.
Does mantle irradiation cause preclinical abnormalities in cardiac function and perfusion in long-term survivors of Hodgkin's disease?
Population
50 long-term survivors of Hodgkin's disease treated with mantle irradiation, ages 10.2-46.1 years at RT
Comparison
No comparison group; assessment of cardiac function and perfusion after mantle irradiation
Design
Observational cohort study using noninvasive cardiac function and perfusion tests
Follow-up
Mean 9.1 years (range 1.1 to 29.1 years) after RT
Authors
Discussion
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Implication
Normal LV function after mantle irradiation supports current techniques in Hodgkin survivors; leaves open whether LV inclusion merits field optimization.
Study Design
Type
Observational (n=50)
Structured PICO
Does mantle irradiation cause preclinical abnormalities in cardiac function and perfusion in long-term survivors of Hodgkin's disease?
P
Population
50 long-term survivors of Hodgkin's disease (mean age 26.0 years at RT) without known cardiac disease, evaluated 1.1 to 29.1 years after mantle irradiation.
E
Exposure
Mantle irradiation (mean central cardiac RT dose 35.1 +/- 7.8 Gy in daily 15-2.0 Gy fractions)
O
Outcome
Left ventricular (LV) systolic and diastolic function (assessed by LVEF and peak filling rate) and regional myocardial blood flowsurrogate
Main Result
Absolute Event Rate: 56.6% vs 60.6%
p-value: p=0.051
Long-term survivors of Hodgkin's disease treated with modern mantle irradiation techniques generally maintain normal left ventricular function and myocardial perfusion.
Cite This Study
Constine et al. (1997) conducted an observational in Hodgkin's disease (n=50). Mantle irradiation vs. Patients without concomitant left ventricle irradiation was evaluated on Left ventricular ejection fraction (LVEF) (p=0.051). Mantle irradiation in long-term survivors of Hodgkin's disease was associated with generally normal left ventricular function, though concomitant left ventricle irradiation slightly lowered LVEF (56.6% vs 60.6%; P=0.051).