"These numbers are encouraging given the condition of the patients, who are too sick to undergo any more catheter ablation procedures," Robinson said. "Given the relative novelty of this treatment approach, we are continuing to follow our patients closely."
Of nine patient deaths, six were from cardiac causes, including heart failure and tachycardia recurrence, and three were from noncardiac causes, including an accident, amiodarone toxicity and pancreatic cancer. Two surviving patients experienced inflammation of the heart lining, a common side effect of this type of radiation therapy, and another developed a fistula between the stomach and the heart and needed surgery to repair it. All three of these adverse events occurred more than two years after therapy. Such side effects emphasize the importance of monitoring the patients for signs of cardiac injury, which is always a possibility following radiation therapy, according to Robinson.
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Despite the severe adverse events, the researchers said they are to be expected when considering how ill these patients are. They emphasized that radiation therapy is the last option and only should be pursued when all other strategies have been exhausted. For such patients, the study suggests their tachycardia is likely to improve, leading to a reduced need for medications with adverse side effects and to an improved quality of life, at least over the first two years following treatment.
Robinson CG, et al. Longer-term results from a phase I/II study of EP-guided noninvasive cardiac radioablation for treatment of ventricular tachycardia (ENCORE-VT). ASTRO Annual Meeting. Sept. 15, 2019.
Washington University School of Medicine's 1,500 faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children's hospitals. The School of Medicine is a leader in medical research, teaching and patient care, ranking among the top 10 medical schools in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children's hospitals, the School of Medicine is linked to BJC HealthCare.
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