Methods for confirming the safety of radiation therapy in patients with left ventricular assist device: a case of extranodal NK/T-cell lymphoma, nasal type.
Left ventricular assist device
Malignancy
Radiation therapy
Testing of the irradiated
Journal
Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs
ISSN: 1619-0904
Titre abrégé: J Artif Organs
Pays: Japan
ID NLM: 9815648
Informations de publication
Date de publication:
Sep 2022
Sep 2022
Historique:
received:
11
11
2021
accepted:
17
01
2022
pubmed:
4
2
2022
medline:
31
8
2022
entrez:
3
2
2022
Statut:
ppublish
Résumé
A left ventricular assist device (LVAD) is a treatment option for patients with end-stage heart failure; however, a certain number of patients on durable LVADs are diagnosed with malignancy. Radiation therapy (RT) for patients with durable LVADs has safety concerns, because RT may interfere with the device. Herein, we report a case of RT during durable LVAD management. A 48-year-old man with a durable LVAD was diagnosed with sinusitis. As his symptoms were resistant to drug therapy, endoscopic sinus surgery was performed, and extranodal NK/T-cell lymphoma, nasal type (ENKL) was pathologically detected. Since RT was the first-line treatment for ENKL, we conducted two types of irradiation experiments to determine whether RT can be safely performed in patients with durable LVADs as follows: (1) assessing the extent of the radiation levels at each site and evaluating device malfunction by irradiating the lesion sites in the patient model with the same protocol as planned, and (2) evaluating device malfunction by directly irradiating the durable LVAD equipment once at the scheduled total dose. The radiation doses at the pump, driveline, system controller, power cable, and power module of the durable LVAD reached 7.86 cGy, 6.34 cGy, 0.66 cGy, 0.38 cGy, and 0.14 cGy, respectively. In both experiments, durable LVAD malfunction or any type of alarm was not observed. We concluded that RT could be safely performed with chemotherapy in this patient and our irradiation experiments can be applied to RT for other malignancies.
Identifiants
pubmed: 35113274
doi: 10.1007/s10047-022-01312-9
pii: 10.1007/s10047-022-01312-9
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
274-278Informations de copyright
© 2022. The Japanese Society for Artificial Organs.
Références
Teuteberg JJ, Cleveland JC, Cowger J, Higgins RS, Goldstein DJ, Keebler M, et al. The society of thoracic surgeons intermacs 2019 annual report: the changing landscape of devices and indications. Ann Thorac Surg. 2020;109:649–60.
doi: 10.1016/j.athoracsur.2019.12.005
Kinugawa K, Nishimura T, Toda K, Saiki Y, Niinami H, Nunoda S, et al. The second official report from Japanese registry for mechanical assisted circulatory support (J-MACS): first results of bridge to bridge strategy. Gen Thorac Cardiovasc Surg. 2020;68:102–11.
doi: 10.1007/s11748-019-01227-y
Loyaga-Rendon RY, Inampudi C, Tallaj JA, Acharya D, Pamboukian SV. Cancer in end-stage heart failure patients supported by left ventricular assist devices. ASAIO J. 2014;60:609–12.
doi: 10.1097/MAT.0000000000000116
Yamaguchi M, Suzuki R, Oguchi M. Advances in the treatment of extranodal NK/T-cell lymphoma, nasal type. Blood. 2018;131:2528–40.
doi: 10.1182/blood-2017-12-791418
Zecchin M, Severgnini M, Fiorentino A, Malavasi VL, Menegotti L, Alongi F, et al. Management of patients with cardiac implantable electronic devices (CIED) undergoing radiotherapy: a consensus document from Associazione Italiana Aritmologia e Cardiostimolazione (AIAC), Associazione Italiana Radioterapia Oncologica (AIRO) Associazione. Int J Cardiol. 2018;255(175):83.
Salerno F, Gomellini S, Caruso C, Barbara R, Musio D, Coppi T, et al. Management of radiation therapy patients with cardiac defibrillator or pacemaker. Radiol Medica. 2016;121:515–20.
doi: 10.1007/s11547-015-0616-z
Nakamura K, Aoyama T, Kaneda N, Otsuji M, Minami Y, Sakuragi A, et al. Implantable cardiac pacemaker failure by cumulative dose effects of flattening filter free beams. J Radiat Res. 2021;62:735–9.
doi: 10.1093/jrr/rrab041
Emerson LY, Deek MP, Almendral J, Jabbour SK, American Society for Radiation Oncology. Radiation therapy in patients with left ventricular assist device: a case report and literature review. Pract Radiat Oncol. 2016;6:e145–7.
doi: 10.1016/j.prro.2015.12.003
Chelikani NM, Masterson K, Down LA, Gill RS, Farar DJ, Horstmanshof DA, et al. Effects of gamma radiation on a ventricular assist device and its percutaneous lead components. ASAIO J. 2012;58:19–24.
doi: 10.1097/MAT.0b013e31823e5bcc