Purpose: This study analyses a large number of cancer patients with CIEDs for device malfunction and premature battery depletion by device interrogation after each radiotherapy fraction and compares different guidelines in regard to patient safety. Methods: From 2007 to 2022, a cohort of 255 patients was analyzed for CIED malfunctions via immediate device interrogation after every RT fraction. Results: Out of 324 series of radiotherapy treatments, with a total number of 5742 CIED interrogations, nine device malfunctions (2.8%) occurred. Switching into back-up/safety mode and software errors occurred four times each. Once, automatic read-out could not be performed. The median prescribed cumulative dose at planning target volume (PTV) associated with CIED malfunction was 45.0 Gy (IQR 36.0–64.0 Gy), with a median dose per fraction of 2.31 Gy (IQR 2.0–3.0 Gy). The median maximum dose at the CIED at time of malfunction was 0.3 Gy (IQR 0.0–1.3 Gy). No correlation between CIED malfunction and maximum photon energy (p= 0.07), maximum dose at the CIED (p= 0.59) nor treatment localization (p= 0.41) could be detected. After excluding the nine malfunctions, premature battery depletion was only observed three times (1.2%). Depending on the national guidelines, 1–9 CIED malfunctions in this study would have been detected on the day of occurrence and in none of the cases would patient safety have been compromised. Conclusion: Radiation-induced malfunctions of CIEDs and premature battery depletion are rare. If recommendations of national safety guidelines are followed, only a portion of the malfunctions would be detected directly after occurrence. Nevertheless, patient safety would not be compromised.
目的：本研究通过每次放疗分次后对大量携带心脏植入式电子设备（CIED）的癌症患者进行设备检测，分析设备故障及电池过早耗竭情况，并比较不同指南在患者安全性方面的差异。方法：2007年至2022年间，对255例患者队列在每次放疗分次后立即进行CIED检测，以分析设备故障情况。结果：在324个放疗疗程（共进行5742次CIED检测）中，发生9例设备故障（2.8%）。其中切换至备用/安全模式和软件错误各发生4次，1次无法执行自动读取。发生CIED故障时，计划靶区（PTV）处方累积剂量中位数为45.0 Gy（四分位距36.0–64.0 Gy），单次分割剂量中位数为2.31 Gy（四分位距2.0–3.0 Gy）。故障时CIED位置最大剂量中位数为0.3 Gy（四分位距0.0–1.3 Gy）。未发现CIED故障与最大光子能量（p=0.07）、CIED位置最大剂量（p=0.59）或治疗部位（p=0.41）存在相关性。排除9例故障后，仅观察到3例（1.2%）电池过早耗竭。根据各国指南，本研究中1-9例CIED故障可在发生当日被检测到，且所有案例均未危及患者安全。结论：放射线诱发的CIED故障及电池过早耗竭较为罕见。若遵循各国安全指南建议，仅部分故障可在发生后被直接检测到，但患者安全仍可得到保障。
肿瘤(癌症)患者之家