Cardiac Tumors: Multimodality Approach, Follow-Up, and Prognosis
Cardiac tumors include mainly primary lymphomas and sarcomas. Cardiac lymphomas are usually treated with chemotherapy (CT), with a good rate of success at least at short-medium term, even if survival is worse than in non-cardiac lymphomas. Surgery may be indicated in selected cases in the presence of life-threatening hemodynamic impairment. Radiation therapy may be considered for palliation in non-response or progressive disease after CT. For cardiac sarcomas the mainstay of treatment is surgery, but CT and radiotherapy (RT) may play a relevant role. Preoperative CT should be considered in unresectable and borderline resectable tumors, to increase the probability of a wide resection with negative margins. Adjuvant CT may be used in high risk tumors. Anthracyclines and ifosfamide are the more active drugs. CT must be planned by a medical oncologist with experience in the management of sarcomas. Postoperative RT may be considered after CT. Combined CT and RT may be considered in unresectable or relapsing tumors to reduce tumor burden and prolong the progression-free survival. Radiation therapy is challenging and must be planned by a radiation oncologist with experience in the management of sarcomas. The collaboration with an experienced cardiologist is recommended. A cardiologic monitoring during treatment should be planned.
- 9.Pi J, Kang Y, Smith M, et al. A review in the treatment of oncologic emergencies. J Oncol Pharm Pract. 2015 Oct 6.Google Scholar
- 11.Ramlawi B, Leja MJ, Abu Saleh WK, et al. Surgical treatment of primary cardiac sarcomas: review of a single-institution experience. Ann Thorac Surg. 2015 Oct 14.Google Scholar
- 14.Ravi V, Benjamin RS. Systemic therapy for cardiac sarcomas. MDCVJ. 2010;VI(3):57–60.Google Scholar
- 26.Taieb S, Saada-Bouzid E, Tresch E, French Sarcoma Group, et al. Comparison of response evaluation criteria in solid tumours and Choi criteria for response evaluation in patients with advanced soft tissue sarcoma treated with trabectedin: a retrospective analysis. Eur J Cancer. 2015;51:202–9.CrossRefPubMedGoogle Scholar
- 27.Choi H, Charnsangavej C, Faria SC, et al. Correlation of computed tomography and positron emission tomography in patients with metastatic gastrointestinal stromal tumor treated at a single institution with imatinib mesylate: proposal of new computed tomography response criteria. J Clin Oncol. 2007;25:1753–9.CrossRefPubMedGoogle Scholar
- 35.Randhawa JS, Budd GT, Randhawa M, et al. Primary cardiac sarcoma: 25-Year Cleveland clinic experience. Am J Clin Oncol. 2014 Jul 17.Google Scholar