Radiotherapy of patients with implantable electronical devices

Czech version

Authors: L. Bobek ¹; P. Burkoň ^1,2; M. Vrzal ¹; A. Odložilíková ¹; V. Peksa ¹; P. Šlampa ^1,2
Authors‘ workplace: Klinika radiační onkologie MOÚ Brno ¹; Klinika radiační onkologie LF MU Brno ²
Published in: Klin Onkol 2020; 33(Suppl 1): 6-14
Category: Review
doi: https://doi.org/10.14735/amko2020S6

Overview

Background: Patients with implanted cardiovascular implantable electronical devices (CIED) undergoing radiotherapy are at a significant risk of malfunction of the device caused by external beam radiotherapy. Device failures are reported in literature ever since first linear accelerators have been in operation in 1960s. The principles of safe irradiation of these patients are developing with a deeper cause analysis of failures. In Europe, the most cited are Dutch Hurkmans’ or DEGRO/DGK guidelines. The American Association of Physicists in Medicine (AAPM) Task Group 203’s Report released in late 2019 is different in several key approaches, especially in the question of maximal accepted dose to the device and the need of ECG monitoring during the treatment. In the light of current knowledge, the AAPM also reduces indications for surgical CIED’s replacement if the recommendations can’t be reached. Purpose: It is necessary for every radiotherapy department to adopt internal directive for CIEDs carrying patient’s treatment. This report brings a complex overview of causes and mechanisms of CIED’s malfunctions and, considering both different patient’s managements, it offers assets for regional guidelines in the Czech Republic.

Keywords:

radiotherapy – pacemaker – implantable cardioverter-defibrillator – CIED

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