Radiation Therapy May Raise Future Death Risk From Heart Surgery

THURSDAY, April 11 (HealthDay News) -- Cancer survivors who had chest radiation therapy have a nearly twofold increased risk of dying in the years after having major heart surgery, a new study finds.

Researchers looked at 173 people who had chest radiation treatment for cancer an average of 18 years before they required heart surgery. These patients were compared to 305 people who underwent similar heart surgeries but had no history of radiation therapy.

The death risk in the first 30 days after heart surgery was about the same for both groups. But during an average follow-up of nearly eight years, 55 percent of the patients in the radiation group died, compared with 28 percent of those in the nonradiation group, the investigators found.

The study was published April 8 in the journal Circulation.

"These findings tell us that if you had radiation, your likelihood of dying after major cardiac surgery is high," study author Dr. Milind Desai, an associate professor of medicine at the Cleveland Clinic, said in a journal news release.

"That's despite going into the surgery with a relatively low risk score. In patients who have had prior [chest] radiation, we need to develop better strategies of identifying appropriate patients that would benefit from surgical intervention. Alternatively, some patients might be better suited for [nonsurgical] procedures," Desai said.

"While radiation treatments done on children and adults in the late 1960s, '70s and '80s played an important role in cancer survival, the treatment often takes a toll on the heart," Desai explained.

"Survivors are at greater risk than people who do not have radiation to develop progressive coronary artery disease, aggressive valvular disease, as well as pericardial diseases, which affect the heart's surrounding structures," he said. "These conditions often require major cardiac surgery."

While the study found an association between chest radiation therapy for cancer and future risk of death after heart surgery, it did not establish a cause-and-effect relationship.

-- Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. SOURCE: Circulation, news release, April 8, 2013

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New Strategy Helps Young Lymphoma Patients Avoid Radiation Treatment

Approach resulted in high remission rates without the risks tied to radiotherapy, researchers say

By Mary Elizabeth Dallas

HealthDay Reporter

WEDNESDAY, April 10 (HealthDay News) -- A new treatment approach may mean that young people with a form of lymphoma can go without radiation therapy, sparing them side effects or raised cancer risks down the road.

In a trial conducted by the U.S. National Cancer Institute, nearly all patients with a form of cancer known as primary mediastinal B-cell lymphoma who received chemotherapy, but did not undergo chest radiation, achieved a full remission.

Standard treatment for this cancer typically includes radiation to the chest, the study authors pointed out, but this has been linked to significant harmful effects in the future, particularly for women.

"These results are exciting and demonstrate that, using this approach, almost all patients appear to be cured and very few patients require radiation," study co-author Dr. Kieron Dunleavy, of the U.S. National Cancer Institute, said in an agency news release.

One expert not connected to the study agreed.

"This study is a significant achievement in improving the care of a group of lymphoma patients that urgently need it: young patients with an aggressive and -- if left untreated -- rapidly lethal disease," said Dr. Joshua Brody, assistant professor of medicine at the Icahn School of Medicine at Mount Sinai in New York City.

The study "yielded very exciting success rates with almost all patients going into complete remission even without the use of radiation therapy, which is frequently used for this disease," Brody added. All of the patients in the study maintained remission "for a long time," he noted, and "most of the patients are certainly cured of their disease."

The study is published in the April 11 issue of the New England Journal of Medicine.

Primary mediastinal B-cell lymphoma usually affects people in their teens to early 30s. Although many people with the disease who are treated with both chemotherapy and radiation do achieve a cure, roughly 20 percent do not, according to an NCI news release.

The research team noted that radiation to the chest area could also boost a patient's risk for other types of cancer down the road, including breast cancer, as well as cause damage to the heart. Complicating matters, as young people age, their risk for heart disease and new forms of cancer also rises.

The NIH trial involved 51 patients with untreated primary mediastinal B-cell lymphoma who were followed over the course of 14 years. The largest tumor diameter of any patient in the study was 11 centimeters.

Each patient received a regimen of drugs known as dose-adjusted EPOCH-R. The regimen included the following drugs: etoposide, doxorubicin, cyclophosphamide, vincristine, prednisone and rituximab. The dosages of these drugs were adjusted to make them as effective as possible.

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Breast Cancer Radiation Has Long-Term Heart Effects: Study

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