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Radiation-associated hypertension in patients undergoing treatment for prostate cancer

Published online by Cambridge University Press:  13 September 2019

Mark Farrugia Open the ORCID record for Mark Farrugia [Opens in a new window]  and
Malcolm Mattes
Mark Farrugia
Affiliation:
Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
Malcolm Mattes*
Affiliation:
West Virginia University, Morgantown, West Virginia, United States
*
Author for correspondence: Malcolm Mattes, West Virginia University, Morgantown, West Virginia, USA. E-mail: [email protected]
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Abstract

Objective:

Patients undergoing prostate radiation therapy were observed to have elevated blood pressures in clinic. Therefore, we sought to further characterise this phenomenon.

Methods:

The charts of 76 patients who received radiotherapy for prostate cancer between 2014 and 2017 were examined. Blood pressure (BP) readings were obtained at initial consultation, on treatment visits, and subsequent follow-up appointments. To describe this effect, we defined radiation-associated hypertension (RAH) as an increase ≥15 mmHg systolic BP, 10 mmHg diastolic BP, or 5 mmHg mean arterial pressure.

Results:

Within this cohort, 36 patients developed RAH, with 75% developing RAH while on treatment, and 25% developing RAH at post-treatment visits. Two-thirds of patients remained hypertensive during post-treatment visits, and 27% were prescribed additional anti-hypertensives. There was no association between neoadjuvant/concurrent androgen deprivation therapy and RAH.

Conclusion:

A significant number of patients undergoing prostate radiotherapy developed RAH, necessitating additional medication in some.

Keywords

cardio-oncologyhypertensionprostate cancersurvivorship
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 19 , Issue 2 , June 2020 , pp. 112 - 115
Copyright
© Cambridge University Press 2019

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References

Lee, C K K, Aeppli, D, Nierengarten, M E. The need for long-term surveillance for patients treated with curative radiotherapy for Hodgkin’s disease: University of Minnesota experience. Int J Radiat Oncol Biol Phys 2000; 48: 169–179. doi: 10.1016/S0360-3016(00)00647-7.CrossRefGoogle ScholarPubMed
Hahn, E, Jiang, H, Ng, Aet al. Late cardiac toxicity after mediastinal radiation therapy for hodgkin lymphoma: contributions of coronary artery and whole heart dose-volume variables to risk prediction. Int J Radiat Oncol Biol Phys 2017; 98: 1116–1123. doi: 10.1016/j.ijrobp.2017.03.026.CrossRefGoogle ScholarPubMed
Herrmann, J, Lerman, A, Sandhu, N Pet al. Evaluation and management of patients with heart disease and cancer: cardio-oncology. Mayo Clin Proc 2014; 89: 1287–1306. doi: 10.1016/j.mayocp.2014.05.013.CrossRefGoogle ScholarPubMed
Zagars, G K, Ballo, M T, Lee, A Ket al. Mortality after cure of testicular seminoma. J Clin Oncol 2004; 22: 640–647. doi: 10.1200/JCO.2004.05.205.CrossRefGoogle ScholarPubMed
Haugnes, H S, Wethal, T, Aass, Net al. Cardiovascular risk factors and morbidity in long-term survivors of testicular cancer: a 20-year follow-up study. J Clin Oncol 2010; 28: 4649–4657. doi: 10.1200/JCO.2010.29.9362.CrossRefGoogle ScholarPubMed
Huddart, R A, Norman, A, Shahidi, Met al. Cardiovascular disease as a long-term complication of treatment for testicular cancer. J Clin Oncol 2003; 21: 1513–1523. doi: 10.1200/JCO.2003.04.173.CrossRefGoogle Scholar
Leibowitz, A, Grossman, E, Berkovitch, A, et al. The effect of head and neck radiotherapy on blood pressure and orthostatic hypotension in patients with head and neck tumors. Am J Hypertens 2018; 31: 235–239. doi: 10.1093/ajh/hpx158.CrossRefGoogle ScholarPubMed
Goyal, M, Shukla, P, Gupta, D, et al. Cardiovascular sequel of neck irradiation in head and neck cancer patients. Int J Radiat Biol 2017; 93: 711–716. doi: 10.1080/09553002.2017.1303217.CrossRefGoogle ScholarPubMed
Howlander, N, Noone, A M, Krapcho, Met al. SEER Cancer Statistics Review, 1975-2015, Bethesda, MD: National Cancer Institute. SEER Cancer Stat. Rev. 1975-2015, Natl. Cancer Institute. Bethesda, MD. https://seer.cancer.gov/csr/1975_2015/, based on N (2018). Accessed 03rd May 2019.Google Scholar
Esposito, K, Chiodini, P, Capuano, A, et al. Effect of metabolic syndrome and its components on prostate cancer risk: meta-analysis. J Endocrinol Invest 2013; 36: 132–139. doi: 10.1007/BF03346748.CrossRefGoogle ScholarPubMed
D’Amico, A V, Chen, M H, Renshaw, Aet al. Long-term follow-up of a randomized trial of radiation with or without androgen deprivation therapy for localized prostate cancer. JAMA 2015; 314: 1291–1293. doi: 10.1001/jama.2015.8577.CrossRefGoogle ScholarPubMed
O’Farrell, S, Garmo, H, Holmberg, Let al. Risk and timing of cardiovascular disease after androgen-deprivation therapy in men with prostate cancer. J Clin Oncol 2015; 33: 1243–1251. doi: 10.1200/JCO.2014.59.1792.CrossRefGoogle ScholarPubMed
Klotz, L, Boccon-Gibod, L, Shore, N Det al. The efficacy and safety of degarelix: a 12-month, comparative, randomized, open-label, parallel-group phase III study in patients with prostate cancer. BJU Int 2008; 102: 1531–1538. doi: 10.1111/j.1464-410X.2008.08183.x.CrossRefGoogle ScholarPubMed
Whelton, P K, Carey, R M, Aronow, W Set al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults. J Am Coll Cardiol 2018; 71: e127. LP-e248. doi: 10.1016/j.jacc.2017.11.006.CrossRefGoogle ScholarPubMed
NCCN. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Prostate Cancer. Version 1.2017 1–111 (2017).Google Scholar
CDC, N. Underlying Cause of Death 1999-2013. CDC WONDER Online Database (2015). https://wonder.cdc.gov/ucd-icd10.html. Accessed on 29th April 2019.Google Scholar
Milutinovic, J, Darcy, M, Thompson, K ARadiation-induced renovascular hypertension successfully treated with transluminal angioplasty: case report. Cardiovasc Intervent Radiol 1990; 13: 29–31.CrossRefGoogle ScholarPubMed
Cardinale, D.Cardio-oncology: a new medical issue. Ecancermedicalscience 2009; 3: 126.CrossRefGoogle Scholar
Guan, J, Khambhati, J, Jones, L W, et al. ABCDE steps for heart and vascular wellness following a prostate cancer diagnosis. Circulation 2015; 132: e218. LP-e220. doi: 10.1161/CIRCULATIONAHA.115.012521.CrossRefGoogle Scholar