Guidelines for Complications of Cancer Treatment Vol VIII Part B

syndrome and bronchiolitis obliterans. CONCLUSION: Anincreased incidence of cardiac and/or pulmonary dysfunctionis observed in cancer survivors. Research is needed to identifyhigh-risk patients, and to determine the optimal screeningstrategies and subsequent treatment.Radiother Oncol. 1998 Jan;46(1):51-62.Cardiac risk after mediastinal irradiation for Hodgkin’s disease.Glanzmann C, Kaufmann P, Jenni R, Hess OM,Huguenin P.Department of Radiation Oncology, University HospitalZurich, Switzerland.PURPOSE: To evaluate the risk of cardiac lesions afterconventionally fractionated irradiation (Rt) of the mediastinewith or without chemotherapy (Ct) in patients with Hodgkin’sdisease (HD) and to relate them to known cardiovascular riskfactors.PATIENTS AND METHODS: Between 1964 and 1992, 352(total group) patients with HD were treated with curativeintention using Rt with or without Ct including the mediastineand had a follow-up of at least 1 year. More than 96% of thepatients had a complete follow-up. One hundred forty-fourpatients (64% of the living patients, heart study group) haveregular follow-up in our department and had a special heartexamination including rest and exercise ECG,echocardiography and myocardial perfusion scintigraphy (112patients). Doses per fraction in the anterior heart region werebetween 1.3 and 2.1 Gy. Total doses were between 30.0 and42.0 Gy in 93% of cases. The mean length of follow-up was11.2 years (range 1.0-31.5 years). Other cardiovascular riskfactors evaluated were body mass index, blood pressure,smoking history, diabetes mellitus, hypercholesterolemia andhistory of coronary artery disease before Rt.309