Stage-II thymoma and emergency coronary artery bypass. To irradiate or not to irradiate to avoid radiation induced vascular injury? Case report and literature review
Kouerinis, I.A.; Tolia, M.; Zagouri, F.; Nikolaou, M.; Tsoukalas, N.; Kyrgias, G.; Dimopoulos, M.A.; Vlachopoulos, C.; Karathanassis, I.; Zoubouli, C.K.; Kokakis, I.; Kouloulias, V.; Triantafillou, K.
Journal of BUON Official Journal of the Balkan Union of Oncology 22(6): 1385-1389
2017
ISSN/ISBN: 1107-0625 PMID: 29332327 Document Number: 694665
The purpose of this study was to present the controversial role of adjuvant radiotherapy to a 72-year-old male patient with Masaoka stage II thymoma and coronary artery bypass and to review the relevant literature. The data were collected by relevant studies on PubMed and EMBASE. Articles up to March 2017 were included. Although the radiation-induced vascular injury to the internal thoracic artery and its suitability for grafting in a patient who is candidate for coronary artery bypass is documented, the possible catastrophic effect of adjuvant radiotherapy to existing grafts in a patient with prior bypass surgery has not been fully investigated. The application of radiotherapy in a patient with R0 stage II thymoma is currently considered of 2B level of evidence but its potential occlusive effect to an underlying coronary graft may dramatically affect the survival of the patient and accordingly drop the level of evidence of its use.