Risk of cardiac implantable device malfunction in cancer patients receiving proton therapy: an overview

Age is a risk factor for both cardiovascular disease and cancer, as such radiation oncologists frequently see number of patients with cardiac implantable electronic devices (CIEDs) receiving proton therapy (PT). CIED malfunctions induced by PT are nonnegligible can occur in passive scattering pencil beam scanning modes. In the absence an evidence-based protocol, authors emphasise that this patient cohort should be managed differently to electron- photon- external (EBRT) due distinct properties beams. Given lack PT-specific guideline managing limited studies on important topic; process was initiated evaluating all PT-related provide baseline future reporting research. review, different modes their interactions variety CIEDs pacing leads discussed. Effects were classified into hardware software malfunctions. Apart from secondary neutrons, cumulative dose, dose rate, model/manufacturer, distance field, materials used CIEDs/pacing evaluated determine probability The importance arrangements highlighted study. Manufacturers specify recommended limits undergoing PT. establishment international multidisciplinary team dedicated CIED-bearing may beneficial.