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Radiation-associated cardiovascular disease.

M Jacob Adams1, Patricia H Hardenbergh, Louis S Constine

  • 1Department of Pediatrics, Division of Pediatric Cardiology, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Box 631, Rochester, NY 14642, USA.

Critical Reviews in Oncology/Hematology
|December 17, 2002
PubMed
Summary
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Chest radiotherapy can cause serious heart problems in cancer survivors. Long-term cardiac follow-up and screening are essential for early detection and management of these radiation-associated cardiovascular toxicities.

Area of Science:

  • Cardiology
  • Oncology
  • Radiotherapy

Background:

  • Growing number of cancer survivors due to therapeutic advances.
  • Increasing importance of understanding long-term treatment complications.
  • Focus on adverse cardiovascular effects of chest radiotherapy.

Purpose of the Study:

  • Present current knowledge on cardiovascular complications of chest radiotherapy.
  • Detail clinical presentations, follow-up, and treatment strategies.
  • Inform management of patients previously exposed to irradiation.

Main Methods:

  • Conducted Medline literature searches.
  • Reviewed abstracts from oncology and cardiology meetings.
  • Synthesized existing data on radiation-induced cardiovascular toxicity.

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Main Results:

  • Mediastinal irradiation can lead to coronary artery disease, pericarditis, cardiomyopathy, valvular disease, and conduction abnormalities.
  • Cardiovascular damage is related to radiation dose, volume, and technique.
  • Relative risk of fatal cardiovascular events increases with time since mediastinal irradiation for Hodgkin's disease and breast cancer.

Conclusions:

  • Radiation-associated cardiovascular toxicity is progressive and lifelong.
  • Long-term cardiac follow-up is essential for cancer survivors.
  • Evidence-based screening regimens for radiation-induced heart disease are needed.