Argumentative Essay On Radiotherapy

In recent years, with the increase in elderly population, more cancer patients with electronic devices such as cardiac pacemaker or internal cardiac defibrillator have been encountered and are treated with radiotherapy. New generation devices are more sensitive to radiation and electromagnetic waves. Device interaction is different according to the type of radiation used. During the radiotherapy planning, the characteristics of the device and the dependence of the patient on the device must be considered. The device should not be in the treatment field, <10 MV energy should be preferred; the cumulative dose should be kept below 2 Gy. Each clinic should prepare its own treatment and emergency protocol and patients should be treated accordingly.

Ionizing radiation for treatment purposes (such as X and Ɣ rays) is used. However, it is reported in the literature that radiation causes various malfunctions on these implanted electronic devices (6,7). Currently, there is a major lack of knowledge about safe radiotherapy application in the presence of cardiac implanted electronic devices in both the field of cardiology and radiation oncology. The American Association of Physicians in Medicine (AAPM) published a guideline in 1994 years (8). However, this guideline has been insufficient in recent years in terms of radiotherapy techniques and developments in cardiac device technology. In this review, points to be considered in the planning and treatment for patients with PM/ICD who will receive radiotherapy will be summarized based on the

It is thought that malfunction is due to (I) ionizing radiation, (II) electromagnetic interference and (III) scatter radiation (7). Ionizing radiation can alter current characteristics and voltage threshold by affecting CMOS in the device. In addition, radiation can produce thermal neutrons interacting with the boron element present in the device. The resulting boron-neutron interaction can produce charged alpha particles and cause electrical current impairment (7). Electromagnetic interference is the confusing of electromagnetic waves generated by a linear accelerator with myocardial potential during radiotherapy. This causes the device's sensing functions to malfunction (6,7). Scattered radiation can play a role in malfunctions, especially in devices remote from the treatment field (7). Radiation induced damage at devices can be temporary or permanent. Various functional impairments such as changes in sensing (loss or false sensing), alters in stimulation (frequency or amplitude), changes in anti-tachyarrhythmia therapy settings in ICDs, premature battery depletion, impairment of programmed settings, deletion of patient records, loss of telemetry is seen