TL-201 PERFUSION SCINTIGRAPHY IN THE EVALUATION OF LATE MYOCARDIAL DAMAGE IN LEFT-SIDE BREAST-CANCER TREATED WITH ADJUVANT RADIOTHERAPY

Purpose: To evaluate late myocardial damage after adjuvant radiotherap y using a mixed-beam (photons plus electrons) technique to treat the i nternal mammary lymph nodes in left-side breast cancer. Methods and Ma terials: A bicycle ergometer stress test coupled with thallium-201 per fusion scintigraphy and analysis by single-photon computed tomography (CT) was performed on 19 patients treated with left-side breast/chest wall and internal mammary radiation for breast cancer between 1987 and 1993, To be sure that we would evaluate late toxicity caused by the i rradiation, patients had to fulfill the following eligibility criteria : left-side breast cancer, treatment between 1987 and 1993 and no recu rrence during follow-up, age less than or equal to 75 years, no known risk for coronary artery disease, no previous chemotherapy, internal m ammary held treated with an association of photons and electrons, and CT scan-based treatment planning. Results: Median age at scintigraphy was 59 years. Two patients did not reach optimal exercise level and we re not evaluable, Among the 17 evaluable patients representing 91.6 pa tient Sears of follow-up, there were no perfusion defects by visual or quantitative analysis. Conclusion: The mixed-beam technique seemed to spare the heart from harmful irradiation and to protect the myocardiu m. Results need to be confirmed on the long-term use of this technique . (C) 1998 Elsevier Science Inc.