@article{oai:repo.qst.go.jp:00045601,
 author = {Oshiro, Yoshiko and Sugahara, Shinji and et.al and 菅原 信二},
 issue = {3},
 journal = {International Journal of Radiation Oncology Biology Physics},
 month = {Nov},
 note = {PURPOSE: To investigate the effect of proton beam therapy (PBT) on implanted cardiac pacemaker function. METHODS AND MATERIALS: After a phantom study confirmed the safety of PBT in patients with cardiac pacemakers, we treated 8 patients with implanted pacemakers using PBT to a total tumor dose of 33-77 gray equivalents (GyE) in dose fractions of 2.2-6.6 GyE. The combined total number of PBT sessions was 127. Although all pulse generators remained outside the treatment field, 4 patients had pacing leads in the radiation field. All patients were monitored by means of electrocardiogram during treatment, and pacemakers were routinely examined before and after PBT. RESULTS: The phantom study showed no effect of neutron scatter on pacemaker generators. In the study, changes in heart rate occurred three times (2.4%) in 2 patients. However, these patients remained completely asymptomatic throughout the PBT course. CONCLUSIONS: PBT can result in pacemaker malfunctions that manifest as changes in pulse rate and pulse patterns. Therefore, patients with cardiac pacemakers should be monitored by means of electrocardiogram during PBT.},
 pages = {723--727},
 title = {Proton Beam Therapy Interference with Implanted Cardiac Pacemakers},
 volume = {72},
 year = {2008}
}