Proton Beam Therapy Interference With Implanted Cardiac Pacemakers

Journal Article · Sat Nov 01 04:00:00 EDT 2008 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2008.01.062· OSTI ID:21128202

Oshiro, Yoshiko ^[1]; Sugahara, Shinji ^[1]; Noma, Mio; Sato, Masato; Sakakibara, Yuzuru ^[2]; Sakae, Takeji ^[3]; Hayashi, Yasutaka ^[1]; Nakayama, Hidetsugu; Tsuboi, Koji; Fukumitsu, Nobuyoshi ^[1]; Kanemoto, Ayae ^[1]; Hashimoto, Takayuki ^[4]; Tokuuye, Koichi ^[1]

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1. Department of Radiation Oncology, University of Tsukuba, Ibaraki (Japan)
2. Department of Cardiovascular Surgery, University of Tsukuba, Ibaraki (Japan)
3. Proton Medical Research Center, University of Tsukuba, Ibaraki (Japan)
4. Division of Radiation Oncology, Shizuoka Cancer Center Hospital, Shizuoka (Japan)

Purpose: To investigate the effect of proton beam therapy (PBT) on implanted cardiac pacemaker function. Methods and Materials: After a phantom study confirmed the safety of PBT in patients with cardiac pacemakers, we treated 8 patients with implanted pacemakers using PBT to a total tumor dose of 33-77 gray equivalents (GyE) in dose fractions of 2.2-6.6 GyE. The combined total number of PBT sessions was 127. Although all pulse generators remained outside the treatment field, 4 patients had pacing leads in the radiation field. All patients were monitored by means of electrocardiogram during treatment, and pacemakers were routinely examined before and after PBT. Results: The phantom study showed no effect of neutron scatter on pacemaker generators. In the study, changes in heart rate occurred three times (2.4%) in 2 patients. However, these patients remained completely asymptomatic throughout the PBT course. Conclusions: PBT can result in pacemaker malfunctions that manifest as changes in pulse rate and pulse patterns. Therefore, patients with cardiac pacemakers should be monitored by means of electrocardiogram during PBT.

• OSTI ID: 21128202
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 3 Vol. 72; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARDIAC PACEMAKERS
ELECTROCARDIOGRAMS
HEART
NEOPLASMS
NEUTRONS
PATIENTS
PHANTOMS
PROTON BEAMS
PULSE GENERATORS
RADIATION DOSES
RADIOTHERAPY