Management of patients with implanted cardiac devices during radiotherapy: results of a Spanish survey in radiation oncology departments

Background: There is an increasing number of patients with cardiac implantable electronic devices (CIED), either pacemakers or defibrillators, who are receiving a course of radiotherapy. Several guidelines have been published by national societies, but no Spanish national guidelines for management of these patients have been published. More importantly, national clinical practice regarding these patients is not standardised.

Materials and methods: Members of the Spanish Breast Cancer Radiation Oncology Group (GEORM in Spanish) were surveyed through an online questionnaire on behalf of the Spanish radiation oncology departments.

Results: Only 39.3% of the Spanish radiation oncology departments have policies aimed at CIED carrier patients. Regardless of that, 96.4% of those who responded to the survey refer these patients to their Cardiology department before the start of the course of radiotherapy, and 17.8% of respondents said to manipulate the CIED without any cardiology department direction. A wide range of responses was obtained related to concepts such as "distance from the irradiation field to the CIED" or "safe accumulated doses".

Conclusions: Our results demonstrate the need for national guidelines for CIED patients and the need to promote educational activities addressed to standardise clinical management of these patients in the radiation oncology departments.