Guide
According to common sense, radiotherapy is a treatment that inhibits and kills cancer cells. But on December 14, the world's most prestigious New England medical journal once again subverted our perception: Researchers at the University of Washington School of Medicine have demonstrated that stereotactic radiotherapy has successfully treated five patients with ventricular tachycardia.
Arrhythmia is very stubborn
Ventricular tachycardia refers to a rapid arrhythmia of bundle branches, myocardial conduction fibers, and ventricular muscles that occur below the His bundle bifurcation. According to statistics, this disease causes 300,000 deaths each year in the United States, which is the main cause of sudden cardiac death.
Currently, standard treatments for ventricular tachycardia include medication and interventional therapy. Among them, interventional therapy involves cardiac catheter radiofrequency ablation. However, this procedure is too risky for many patients and is prone to recurrence.
Dr. Clifford G. Robinson, associate professor of radiation oncology, has been exploring new uses for stereotactic radiotherapy as a radiation oncologist specializing in lung cancer. In addition, Associate Professor Phillip S. Cuculich, the lead author and cardiologist, is also looking for new ways to treat ventricular tachycardia. So they began to try to treat ventricular tachycardia with stereotactic radiotherapy.
Five of the patients with ventricular tachycardia published in the New England Journal of Medicine have not responded to standard therapy and have accumulated more than 6,500 episodes within 3 months of receiving the new therapy.
New therapy is amazing
The researchers first performed accurate imaging of the patient's heart (MRI, CT, PET scans), which pinpoints the patient's arrhythmia. The patient then receives targeted radiation therapy, consistent with the dose of early lung cancer patients.
Traditional cardiac catheter ablation may take 6 hours or more, requiring general anesthesia, and the new treatment is completely non-invasive. The researchers said that imaging and ECG are time consuming, but the treatment itself takes only 10-15 minutes. Cuculich thought it was incredible. "It's amazing to see a patient with ventricular tachycardia receiving treatment for a few minutes and then standing up and out."
These patients had a cumulative episode of only 680 episodes after 6 weeks of receiving radiotherapy. During the following 1-year follow-up period, the researchers continued to follow up on the patient's condition and the two patients did not have any seizures. Researchers are also monitoring the long-term side effects of radiation therapy.
It is worth noting that patients do not take effect immediately after receiving targeted radiotherapy. In the 6 weeks after treatment, the number of arrhythmia episodes decreased, but did not completely disappear, the researchers believe that there is a recovery period. Then, after 6 weeks, the number of episodes of arrhythmia is almost zero, and the drug used to control arrhythmia can be slowly reduced. One of the five patients, 82 years old, died within one month of receiving treatment, and the researchers said that the cause of death is unlikely to be related to treatment.
Currently, researchers are recruiting patients for clinical trials to further evaluate this therapy. To date, 23 patients have been treated. We look forward to the day when this treatment can serve as a standard treatment for more patients, and of course more research is needed.
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