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Radiation Matters of the Heart: A Mini Review - PubMed

  • ️Mon Jan 01 2018

Review

Radiation Matters of the Heart: A Mini Review

Kareena M Menezes et al. Front Cardiovasc Med. 2018.

Abstract

Radiation Therapy (RT) has been critical in cancer treatment regimens to date. However, it has been shown that ionizing radiation is also associated with increased risk of damage to healthy tissues. At high radiation doses, varied effects including inactivation of cells in treated tissue and associated functional impairment are seen. These range from direct damage to the heart; particularly, diffuse fibrosis of the pericardium and myocardium, adhesion of the pericardium, injury to the blood vessels and stenosis. Cardiac damage is mostly a late responding end-point, occurring anywhere between 1 and 10 years after radiation procedures. Cardiovascular disease following radiotherapy was more common with radiation treatments used before the late 1980s. Modern RT regimens with more focused radiation beams, allow tumors to be targeted more precisely and shield the heart and other healthy tissues for minimizing the radiation damage to normal cells. In this review, we discuss radiation therapeutic doses used and post-radiation damage to the heart muscle from published studies. We also emphasize the need for early detection of cardiotoxicity and the need for more cardio-protection approaches where feasible.

Keywords: cardiovascular disease; charged particle therapy; heavy ion radiotherapy; ionizing radiation cardiotoxicity; proton therapy; radiation damage to the heart; radiation therapy.

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Figures

Figure 1
Figure 1

Age at first radiation treatment from 15 years through 74 years are shown with calculated Absolute Excess Risk (AER) per 1,000 patients is depicted with data from Swerdlow et al. (48). Higher the age, the greater the risk with about 50% around age 45 years and almost 100% by age 65 years.

Figure 2
Figure 2

A comparison of radiation treatment via spinal axis and the estimated dose received at the heart for X-Ray, IMRT, and Proton procedures. Data is adopted from St Clair et al. (80).

Figure 3
Figure 3

Depiction of worldwide patients treated with protons and carbon ions as of 2017 indicating largest number patients treated with protons (75,896) in the US and patients treated with carbon ions (17,331) in Japan. Data is adopted from PTCOG, Particle Therapy Co-Operative Group (

https://www.ptcog.ch/

).

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