The study find that Radiotherapy has been shown to cause malfunction of implantable cardioverter-defibrillators, and there are few studies of implantable cardioverter-defibrillators and radiotherapy. We report an unusual case of small cell lung cancer in a patient with an implantable cardioverter-defibrillator in whom direct irradiation to the electrode ;and lead  not be avoid. We report a case of radiotherapy in a 72-year-old Korean man with a limited stage of small cell lung cancer who had undergone insertion of an implantable cardioverter-defibrillator because of ventricular fibrillation.

Radiotherapy has been shown

The radiation dose was 60 Gy in 30 fractions to the thorax. The mean dose and maximum dose estimate at the body of the implantable cardioverter-defibrillator were 0.89 Gy and 2.23 Gy; respectively. The mean and maximum doses of the lead and electrode are 17.12 Gy and 55.72 Gy in the lead and 1.81 Gy and 7.10 Gy in the electrode; respectively, because part of the lead and electrode was inevitably in the irradiated fields. The function of the patient’s implantable cardioverter-defibrillator was checked daily; and no change in implantable cardioverter-defibrillator function was observed for the duration of radiotherapy.

The patient is tolerate the treatment well without severe complications. Computed tomography performed at 4 weeks after radiotherapy showed a good response with regression of the tumor. The patient was alive with complete remission of the tumor and without any implantable cardioverter-defibrillator dysfunction more than 36 months after the end of treatment. Therefore This case demonstrates that radiotherapy may be a safe and effective treatment modality through careful monitoring of implantable cardioverter-defibrillators in patients with lung cancer who have implantable cardioverter-defibrillators.

Tolerated the treatment

As the use of cardiac implantable electronic devices (CIEDs); such as permanent pacemakers or implantable cardioverter-defibrillators (ICDs) in the management of cardiovascular disease has increased with increasing life expectancy; so has the indication of radiotherapy in comorbidity of cancer and cardiovascular disease with CIEDs. Radiotherapy has been shows to cause malfunction of CIEDs; ranging from device programming, to inappropriate triggering or inhibition of device therapies; or to complete device failure.

There are a few studies of ICD and radiotherapy, citing values of 1–2 Gy for a tolerable cumulative dose; which is an estimate requiring further research. Although ICDs are compose of a body (generator) and wires (electrode and lead); these reports are chiefly focus on the pacemaker or the body of the ICD. The effect of radiotherapy on electrodes and leads of ICDs are unclear. We present an unusual case of small cell lung cancer in a patient with an ICD who could not avoid direct irradiation to the electrode and lead; and we describe his successful radiotherapy outcome.