Preliminary study of stereotactic cardiac radioablation in radiotherapy of ventricular arrhythmia
Li Jing1, Chen Qingyong2, Li Guangjun1, Li Yan3, Zhang Yingjie1, Li Changhu1, Bai Long1, Zhong Renming1, He Yinbo1, Bai Sen1, Yang Qing2, Xu Feng3
1Department of Radiotherapy, Oncology Center, West China Hospital, Sichuan University, Chengdu 610041, China; 2Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610041, China; 3Lung Cancer Center, WestChina Hospital, Sichuan University, Chengdu 610041, China
Abstract：Objective To introduce the stereotactic cardiac radioablation (SCRA) based on the stereotactic body radiotherapy (SBRT), and comprehensively evaluate the new approach by short-term effectiveness and safety. Methods Patients with ventricular arrhythmia (VA) were evaluated and included in this clinical trial, who were immobilized by vacuum bag and performed simulation with 4-dimensional computed tomography (4DCT). In this study, the planning target volume (PTV) was set as the target to design a SBRT plan using volumetric modulated arc therapy (VMAT), which was evaluated by dose parameters such as R50%, homogeneity index and conformity index, etc. The results of Holter and echocardiography were monitored during the follow-up and compared with the data before treatment. Results Three subjects with ventricular tachycardia (VT) and one with premature ventricular contraction (PVC) received the same prescription of 25Gy in a single fraction. The average volume of PTV was 71.4cm3(60.3-89.4cm3). The average time of beam delivery was 12.0min (4.5-21.0min). And the short-term follow-up lasted for an average of 18 weeks (14-25 weeks), which showed significant decrease in both VT and PVC load without complications. Conclusion This study reports the implementation method of SCRA and proves its short-term effectiveness and safety, but the effects and standards of the key radiotherapy techniques still need to be explored.
Li Jing,Chen Qingyong,Li Guangjun et al. Preliminary study of stereotactic cardiac radioablation in radiotherapy of ventricular arrhythmia[J]. Chinese Journal of Radiation Oncology, 2022, 31(3): 260-265.
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