Evaluation of ECG changes after Radiotherapy of left chest wall by Electron in patients with left breast cancer who receive Anthracycline based chemotherapy following mastectomy

• Main Authors: J Emami, S Hemati, K Mohammadian
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2005-03-01
• Series: Journal of Research in Medical Sciences
• Online Access: http://journals.mui.ac.ir/jrms/article/view/143
• ISSN: 1735-1995; 1735-7136

Background: Cardiovascular damage after Radiotherapy of left chest wall for left breast cancer is a potential fear, therefore
 studing both the possible causes of radiation-induced heart damage and preventive measures are crucial issues in radiation
 therapy of breast cancer. The present study investigates noninvasively the possible acute and chronic ECG changes and their
 incidences after Radiotherapy in patients with left sided breast cancer who have received 6-8 courses of Anthracycline based
 chemotherapy following mastectomy.
 Methods: 56 patients with breast cancer (invasive ductal carcinoma) who had been undergone modified radical mastectomy,
 adjuvant Anthracycline based chemotherapy, and left sided chest wall electron therapy with direct field, have been evaluated.
 All patients investigated with physical examination and standard 12 leads ECG before, and immediately after completion of
 radiation therapy, and 6 months afterward.
 Results: New electrocardiographic changes after therapy were seen in 3 patients (5.35%) and reduced to 2 cases (3.57%)
 after 6 months. there was no significant difference in T wave findings before and after radiation therapy(P=0.521).Also there
 wasn’t any correlation between stage of cancer and any changes in ECG findings after radiation therapy (P=0.56).
 Conclusion: There were no clinical cardiac symptoms or signs after Radiotherapy. Most affected leads in ECG were
 V1-V4 and the main abnormality was Inverted T wave. This findings suggest that the most acute and chronic electrocardiographic
 effect of irradiation on heart is repolarization abnormality.
 This study suggests that there are no significant ECG changes after Radiotherapy of left chest wall by electron beam in
 patients with left sided breast cancer who has received Anthracycline based chemotherapy following mastectomy. Also
 Radiotherapy by electron doesn't induce any clinical cardiac symptoms and signs in these patients.
 Therefore, we recommend using electron beam for Radiotherapy of patients with left sided breast cancer after radical
 mastectomy if Anthracycline based chemotherapy, has been administered.
 Keywords: Electrocardiogram changes, Radiation therapy, Anthracycline based Chemotherapy.