Arya Amini, Vlad G Zaha, Eman Hamad, Pamela K Woodard, Andreas Rimner, Joe Y Chang, Stephen G Chun, Jessica Donington, Martin J Edelman, Matthew A Gubens, Kristin A Higgins, Puneeth Iyengar, Aditya Juloori, Benjamin Movsas, Matthew S Ning, Henry S Park, George Rodrigues, Andrea Wolf, Charles B Simone
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引用次数: 0
Abstract
Purpose: The multidisciplinary American Radium Society (ARS) Thoracic Committee was assigned to create Appropriate Use Criteria (AUC) on cardiac toxicity prevention and management for patients undergoing radiotherapy.
Methods and materials: A systematic review of the current literature was conducted. Case variants of patients with thoracic malignancies undergoing radiation were created based on presence or absence cardiovascular risk factors and treatment-related risks assessed by dose exposure to the heart/cardiac substructures. Modified Delphi methodology was used by to evaluate the variants and procedures, with ≤3 rating points from median defining agreement/consensus.
Results: 6 variants were evaluated. The panel felt patients with cardiac comorbidities at high risk for radiation-related cardiac toxicity should undergo a prescreening cardiac focused history and physical (H&P) exam, electrocardiogram (EKG), cardiac imaging including an echocardiogram, and referral to a cardiologist/cardio-oncologist. Recommendations for those without cardiac comorbidities at low risk for cardiac toxicity were to undergo a baseline history and physical examination only. Conversely, those without cardiac comorbidities but at high risk for radiation-related cardiac toxicity were recommended to undergo a prescreening EKG, in addition to a H&P exam. For patients with cardiac comorbidities at low risk for cardiac toxicity, the panel felt prescreening and post-screening tests may be appropriate.
Conclusions: The ARS Thoracic AUC panel has developed multidisciplinary consensus guidelines for cardiac toxicity prevention, surveillance, and management after thoracic radiotherapy based on cardiac comorbidities at presentation and risk of radiation-related cardiac toxicity.
美国镭学会™ 《胸部放疗后心脏毒性预防和处理的适当使用标准》(American Radium Society™ Appropriate Use Criteria on Cardiac Toxicity Prevention and Management After Thoracic Radiotherapy)。
期刊介绍:
Journal of Thoracic Oncology (JTO), the official journal of the International Association for the Study of Lung Cancer,is the primary educational and informational publication for topics relevant to the prevention, detection, diagnosis, and treatment of all thoracic malignancies.The readship includes epidemiologists, medical oncologists, radiation oncologists, thoracic surgeons, pulmonologists, radiologists, pathologists, nuclear medicine physicians, and research scientists with a special interest in thoracic oncology.