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08:34
Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies
Published on: February 6, 2019
[Normal tissue tolerance to external beam radiation therapy: cardiac structures].
J Doyen1, P Giraud, Y Belkacemi
1Service d'Oncologie-Radiothérapie, Centre Antoine-Lacassagne, 33 Avenue de Valombrose, 06189 Nice cedex 2, France.
Summary
Radiation therapy for thoracic tumors can cause heart damage. Key risk factors include prior chemotherapy and radiation dose, necessitating careful planning to minimize cardiac toxicity.
Area of Science:
- Cardiology
- Oncology
- Radiotherapy
Background:
- Thoracic radiation therapy poses a risk of cardiac toxicity due to the heart's central location.
- Cardiac complications are a significant concern following radiation for breast cancer and mediastinal lymphoma.
Purpose of the Study:
- To review cardiotoxicity associated with radiotherapy for various tumor sites.
- To identify risk factors for radiation-induced heart damage.
Main Methods:
- Literature search of Medline using keywords: cardiac, heart, radiotherapy, toxicity, cardiotoxicity, breast cancer, lymphoma.
- Review of reported clinical complications and risk factors.
Main Results:
- Most frequent complications include pericarditis, congestive heart failure, and myocardial infarction, often asymptomatic.
- Anthracycline treatment significantly increases cardiotoxicity risk.
- Radiation dose parameters (total dose, dose per fraction, irradiated volume) correlate with toxicity risk.
Conclusions:
- Careful radiotherapy planning, including dose constraints (e.g., heart volume <30% at 35 Gy, dose/fraction ≤2 Gy), is crucial.
- Managing cardiovascular risk factors and considering combined treatments (chemotherapy, targeted therapy) are vital for prevention.
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