Multimodal Safeguards Against Oncological Relapse and Therapy-Induced Cardiotoxicity
A Case Study
DOI:
https://doi.org/10.56226/139Keywords:
Cardiotoxicity, Breast Cancer, Lung Cancer, Radiotherapy, CardioprotectionAbstract
Introduction: A 65-year-old woman had been cured of breast cancer 15 years earlier (2010) with a regimen that included doxorubicin, and despite prolonged survival, cardiac evaluation revealed preexisting subclinical myocardial dysfunction. The central challenge arose with the diagnosis of locally advanced non-small cell lung cancer in 2024, requiring thoracic radiotherapy, which presented a significant risk of worsening her previous cardiac impairment.
Methods: The investigation of the patient's new condition began with respiratory symptoms, and the diagnosis of NSCLC was confirmed by chest X-ray, contrast-enhanced computed tomography, and CT-guided lung biopsy with pathological examination and immunohistochemistry. A whole-body PET/CT scan was used for staging, revealing no distant metastases. A detailed cardiac evaluation before treatment revealed borderline left ventricular ejection fraction and decreased global longitudinal strain, confirming preexisting type I cardiotoxicity. Given the diagnosis of NSCLC, a multidisciplinary treatment plan focused on cardio-protection was defined, with early introduction of an angiotensin-converting enzyme inhibitor and a beta-blocker before starting radiotherapy. The article followed the CARE protocol for Case Studies.
Conclusion: The patient completed radiotherapy for NSCLC without experiencing severe acute cardiac toxicity during treatment. The lung tumour demonstrated a good therapeutic response.
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