Correlation Between Chest Radiotherapy And Electrocardiogram Changes And Analysis Of Influencing Factors

Objective:To investigate the relationship between chest radiotherapy and abnormal electrocardiogram and the possible influencing factors of abnormal electrocardiogram.Methods: Patients admitted to the first affiliated hospital of Wannan medical college,Yijishan Hospital from January 1,2016 to July 1,2018 were retrospectively analyzed,There were 202 cases,including 133 cases of middle and lower esophageal cancer,28 cases of left lung cancer,37 cases of left breast cancer,and 4 cases of other breast tumors.There were 134 males and 68 females aged 38-89,with a median age of 67 and an average age of 65.Low-temperature thermoplastic film was used for location fixation,CT machine scanning and positioning,and Raystation planning system collected and processed image information.All patients were treated with linear accelerator 6mv-x-ray irradiation,three-dimensional conformal intensity-modulated radiotherapy technology,2.0Gy/ time,5 times/week,a total of 25-30 times.129 people had accumulated dose <60Gy,and 73 people had accumulated dose 60 Gy.The radiation dose to the heart was about 15-43 gy,among which 51 patients had the irradiated volume of the heart <50%,and 151 patients had the irradiated volume of the heart 50%.Among them,81 patients aged <65 years old and 121 patients aged 65 years old.Results:1.202 patients after radiotherapy review electrocardiogram(ecg)tip: ST-t change in 24 cases,8 cases of sinus bradycardia,sinus tachycardia,3 cases I degree atrioventricular block in 2 cases,10 cases of room sex premature beat,ventricular premature beat(3 cases),left ventricular high voltage in 5 cases,5 cases with right bundle branch block,limb conduction low voltage(3 cases),left atrial overload in 2 cases,with 65 cases of abnormal ecg in 202 patients,the total incidence was 32.18%.2.There were 129 patients with cumulative dose <60Gy,23 patients with ecg abnormality,accounting for 17.83% of the group,73 patients with cumulative dose 60 Gy,42 patients with ecg abnormality,accounting for 57.53%,and the difference was statistically significant(P=0.000).3.Among the 202 patients,the irradiation dose to the heart was about 15-43 gy,among which 51 patients had the irradiation volume of the heart <50%,9 patients had arrhythmia,and the incidence was 17.65%.There were 151 patients with heart irradiation volume 50% and 56 patients with abnormal ecg,and the incidence of abnormal ecg accounted for 37.08% of the group,with statistically significant difference(P=0.010).4.Among the 202 patients,the age range was 38-89 years old,the median age was 67 years old,and the average age was 65 years old.Among them,81 patients <65 years old had ecg changes,and 17 patients had ecg changes after radiotherapy,accounting for 20.99% of the group.There were 121 patients aged 65 years old and 48 patients with ecg abnormality,accounting for 39.67%.The difference was statistically significant(P=0.005).5.Logistic regression analysis indicated that the electrocardiogram results were significantly correlated with the radiotherapy dose and the irradiated volume of the heart.Conclusion:1.Cumulative radiotherapy to the heart area can result in ecg changes in some patients,and st-t changes are the most common type.2.The cumulative dose of chest radiotherapy and the irradiated heart volume were significantly correlated with the occurrence of abnormal ecg,and the incidence of patients with cumulative dose 60 Gy and irradiated heart area 50% was significantly increased.