The impact of particle radiotherapy on the functioning of cardiac implantable electronic devices: a systematic review of in vitro and in vivo studies according to PICO criteria.
Amelia BarcelliniVeronica DusiAlfredo MirandolaSara RonchiGiulia RivaFrancesca Dal MasMaurizio MassaroViviana VitoloMario CioccaRoberto RordorfEster OrlandiPublished in: La Radiologia medica (2022)
The number of oncological patients who may benefit from proton beam radiotherapy (PBT) or carbon ion radiotherapy (CIRT), overall referred to as particle radiotherapy (RT), is expected to strongly increase in the next future, as well as the number of cardiological patients requiring cardiac implantable electronic devices (CIEDs). The management of patients with a CIED requiring particle RT deserves peculiar attention compared to those undergoing conventional photon beam RT, mostly due to the potential generation of secondary neutrons by particle beams interactions. Current consensus documents recommend managing these patients as being at intermediate/high risk of RT-induced device malfunctioning regardless of the dose on the CIED and the beam delivery method used, despite the last one significantly affects secondary neutrons generation (very limited neutrons production with active scanning as opposed to the passive scattering technique). The key issues for the current review were expressed in four questions according to the Population, Intervention, Control, Outcome criteria. Three in vitro and five in vivo studies were included. Based on the available data, PBT and CIRT with active scanning have a limited potential to interfere with CIED that has only emerged from in vitro study so far, while a significant potential for neutron-related, not severe, CIED malfunctions (resets) was consistently reported in both clinical and in vitro studies with passive scattering.
Keyphrases
- end stage renal disease
- early stage
- ejection fraction
- radiation therapy
- newly diagnosed
- locally advanced
- chronic kidney disease
- prostate cancer
- peritoneal dialysis
- randomized controlled trial
- radiation induced
- left ventricular
- squamous cell carcinoma
- rectal cancer
- current status
- climate change
- artificial intelligence
- clinical practice
- risk assessment
- human health
- minimally invasive
- diabetic rats
- endothelial cells
- data analysis