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Query: UMLS:C0019829 (Hodgkin's disease)
 30,247 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Coronary lesions are one of the complications of mediastinal radiotherapy; they are more uncommon, at least in their clinical expression, than the involvement of the pericardium, but they are interesting by their gravity and occurrence in young patients (35 years old, in an average). We are reporting 7 cases in addition to the 53 already recorded in the literature. The neoplasm which led to the radiation treatment is, in 85 p. cent of the cases Hodgkin's disease and in 10 per cent of the cases a breast cancer. The time of occurrence of the clinical signs is of 5 years, in an average. The revealing symptom is an initial necrosis or an angor, most often unstable (45 p. cent of the cases, for each of them), more exceptionnally it is a sudden death or a pericarditis. The coronary risk factors have been determined in 37 patients; 45 p. cent had none. In half of the cases, the coronary involvement is monotruncular and frequently proximal (the anterior interventricular trunk is affected twice as often as the right coronary); in the other half, there is an equal distribution between bi-troncular and tri-truncular involvement. There are various pathological lesions: typical with isolated fibrosis of the intima and aventitia, pure atherosclerotic lesions or association of the two. The prognosis of these coronary lesions is severe (43 p. cent of deaths), but the patients who underwent revascularization procedures (by-pass or more seldom transluminal angioplasty) have in 80 p. cent of the cases a favorable evolution.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Post-radiation coronary diseases. Presentation of 7 cases and review of the literature]. 331 42

The main indices of cardiohemodynamics, phase structure of the cardiac cycle and ECG were studied in 34 patients with Hodgkin's disease aged 16 to 43: before the initiation of therapy, after a course of radiotherapy and in long term after therapy. The patients were characterized by tachycardia increasing with a degree of a process, ECG signs of myocardiodystrophy, a tendency to the formation of the phase syndrome of hypodynamia, slight pulmonary hypertension, a decrease in AP and peripheral vascular resistance. After a course of radiotherapy according to a radical program functional indices of the cardiovascular system in most of the patients returned to normal. However signs of radiation pericarditis with a favorable clinical course developed in some patients. Long after therapy positive changes in the cardiovascular system were noted among patients with IIA stage, negative shifts were noted in patients with III-IV stage.
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PMID:[Functional status of the cardiovascular system in Hodgkin's disease and the effect of radiotherapy]. 333 79

From 1972 to 1976 patients at the Gustave Roussy Institute were irradiated for Hodgkin's disease using a modified fractionation schedule (3 fractions of 3.3 Gy per week) for operational reasons. From 1964 to 1971 and from 1977 to 1981, a more conventional regimen (4 fractions of 2.5 Gy per week) was used. The rates of the late complications in these two subsets of patients treated with different fractionation schedules at the same total dose of 40 Gy during the same overall time were compared. Mediastinitis was observed in 19% of the '4 X 2.5 Gy/week' group versus 56% in the '3 X 3.3 Gy/week' group. Pericarditis in 0% versus 9%, gastroduodenal ulceration and severe gastritis in 10 versus 21% and small bowel obstruction in 5 versus 8%. When using the linear quadratic model with an alpha/beta of 2.5 Gy to evaluate the equivalent dose of 40 Gy given in 12 fractions of 3.3 Gy when delivered by fractions of 2.5 Gy, a value of 46.6 Gy is found. This difference of 6.6 Gy in the equivalent doses (for late toxicity) is likely to account for the significant increase of late radiation injuries, such as mediastinitis and pericarditis, in the present study. The local relapse rate was found to be slightly lower in the 3 X 3.3 Gy group. However, this possible benefit cannot offset the considerable increase of late complications.
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PMID:Late toxicity of radiotherapy in Hodgkin's disease. The role of fraction size. 339 Mar 43

The effects of combined therapy (polychemotherapy and radiotherapy) of 162 patients with stage I-II Hodgkin's disease were studied. A retrospective analysis of x-ray findings led to the detection of exudate in the pericardial cavity unrecognized in hospital in 7.7% of the patients. Combined therapy caused its reverse development into adhesive pericarditis. X-ray assessment of the cardiac state during a follow-up (3-5 yrs.) revealed various postradiation complications: limited pleuropericardial adhesions (17%), extensive pleuropericardial adhesions revealing the right spinal contour (12.7%), exudative pericarditis (0.7%), and adhesive pericarditis (12.7%). A low rate and degree of postradiation injuries of the pericardium could be accounted for by preliminary polychemotherapy making it possible to reduce radiation fields in subsequent irradiation.
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PMID:[Status of the heart during a combined method of treating patients with stage I to II lymphogranulomatosis]. 339 53

Postradiation pericarditis was diagnosed in 11 of 52 patients treated for lymphogranulomatosis with radiation applied to enlarged mediastinal lymph nodes. The risk of postradiation pericarditis is greater in cases of high radiation doses (more than 45 Gy) and in patients with postradiation pneumonitis. Postradiation pericarditis can develop both during the exposure and long after radiation therapy; therefore long-term follow-up is required for these patients.
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PMID:[Postradiation pericarditis in lymphogranulomatosis patients]. 356 Jun 7

Twenty-eight patients younger than age 40 years, treated for Hodgkin's disease with mediastinal irradiation, were examined no less than 5 years after the irradiation in order to evaluate the frequency of cardiac abnormalities. Twelve patients (43%) had had some pericardial event after radiation: a diagnosed pericarditis, remarkably increased heart volume, or a conspicuous change of cardiac silhouette, suggesting pericardial fluid. On evaluation, 50% of the patients complained of symptoms, and 13 patients had to stop the exercise test on a low level because of chest pain, dyspnea, or general fatigue. In 13 patients some of the following abnormalities in the electrocardiogram (ECG) was found: right bundle branch block (four), first-degree atrioventricular block (four), abnormal P terminal force (five), or a low voltage (two). In ten patients (38%) an increase of the pericardial fluid was seen in the echocardiogram, and in nine patients the right ventricle wall thickness had increased. In two patients a severe coronary artery disease was found. One died suddenly after an acute myocardial infarction (AMI), and the other had a large anterior AMI. Two patients with chronic pericardial fluid underwent partial pericardectomy. Two cases of mild pulmonary valve stenosis, one pulmonary subvalvular stenosis and two aortic valve deformities were discovered. Eight patients went through cardiac catheterization, and in all but one case the pressures were slightly elevated suggesting diminished diastolic compliance. In summary, 19 of 28 patients had some abnormal cardiac findings, but only three of them were serious ones.
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PMID:Late cardiac effects of mediastinal radiotherapy in patients with Hodgkin's disease. 358 Oct 32

Echocardiographic examination of 56 patients with lymphogranulomatosis involving lymphatic mediastinal nodes showed in four cases a paradoxical excursion of the interventricular septum and systolic thickening ("isosceles triange") of the posterior left ventricular wall. Clinico-instrumental examination of the patients made it possible to rule out in these subjects the presence of constrictive pericarditis, which had been formerly considered one of the causes of a disturbance of left ventricular kinetics.
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PMID:Impairment of left ventricular kinetics in lymphogranulomatosis with involvement of lymphatic mediastinal nodes. 379 8

Eighty-three patients with Hodgkin's disease were treated with a combination of chemotherapy and radiotherapy. 43 were included in protocol 1 (from january 1970 to january 1974) and 40 in protocol 2 (february 1974 to december 1977). In protocol 1, staging laparotomy was not systematically performed (20 cases). Treatment consisted of 2 intravenous injections in Vinblastine and total nodal irradiation. In protocol 2, laparotomy was systematic in patients over 50 (35 cases). Patients with stages 1 and II treated as mentioned above. Patients with stage III received two Mopp courses followed by total nodal irradiation. Patients older than 50 with stages I and II and poor prognosis factors received chemotherapy only. Laparotomy was associated with a 0% mortality rate and a 3,6% morbidity rate. No myelitis or pericarditis were observed. Herpes zoster occurred in 24% of the patients, pulmonary apex fibrosis in 6%, hypothyroiditis in 2,4%, and leucopenia in 3,6%. Two late infectious complications were fatal. No solid tumor was apparent. Acute leukemia and non-Hodgkin malignant lymphoma developed in two patients. Good tolerance, shortness of treatment, and remission rate, warrant the pursuit of protocol 2 in which systematic laparotomy for patients under 50 allows total nodal irradiation and therefore reduction of chemotherapy.
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PMID:[Non-gonadic complications of chemoradiotherapy in Hodgkin's disease. A study of eighty-three patients (author's transl)]. 628 Feb 86

A case of an acute myocardial infarction occurring in a 19-year-old woman, 27 months after mantle radiotherapy for Stage II-A Hodgkin's disease is described. The coronary arteriogram demonstrated patent and normal coronary arteries, but the echocardiogram revealed pericarditis. The clinical course was further complicated by variant type of angina pectoris which could not be prevented by treatment with vasodilators, but subsided promptly to corticosteroid therapy. It is suggested that radiation induced pericarditis triggered coronary vasospasm leading to the myocardial infarction and to variant angina pectoris.
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PMID:Acute myocardial infarction with normal coronary arteriogram after mantle field radiation therapy for Hodgkin's disease. 630 80

This is a retrospective review of 193 evaluable patients treated with radiation therapy to the mediastinum for Stages I, II and III-A Hodgkin's disease. Eligible patients were those receiving 3000 rad or more to the mediastinum and no chemotherapy prior to the radiation. During the study period, 13 patients developed symptomatic pericarditis. The interval post treatment to the development of symptoms was six to 34 months. The incidence of pericarditis was studied as a function of: (1) the dose of radiation at a depth of 2 cm, 5 cm and the midplane of the mediastinum; (2) the ratio of anterior to posterior weighting of dose; (3) the presence or absence of intrathoracic tumor; (4) the size of the tumor when present; and (5) the fraction of the heart exposed to the radiation beam. There was a significant increase in the incidence of pericarditis with an increased dose of radiation at 2 cm, 5 cm and midplane depths and also with the presence of a large intrathoracic tumor. A reduction in mediastinal dose is recommended.
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PMID:Symptomatic radiation-induced pericarditis in Hodgkin's disease. 643 6


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