A roadmap for modelling radiation-induced cardiac disease

Area of Science:

• Oncology
• Cardiology
• Radiation Oncology

Background:

• Cancer treatments, including radiotherapy (RT), significantly impact patient survival rates.
• Radiotherapy (RT) is a common cancer treatment, affecting over half of adult cancer patients.
• Radiation-induced cardiac disease (RICD) is a growing concern for cancer survivors, necessitating improved risk assessment.

Purpose of the Study:

• To review current evidence and identify knowledge gaps in predicting radiation-induced cardiac disease (RICD).
• To propose a roadmap for developing comprehensive RICD prediction models.
• To enhance long-term outcomes for cancer survivors by addressing cardiac risks.

Main Methods:

• Reviewing existing literature on radiation-induced cardiac disease (RICD) prediction.
• Analyzing the shift from whole-heart metrics to cardiac substructure dosimetry.
• Identifying the role of non-RT factors and novel biomarkers in cardiac risk.

Main Results:

• Cardiac substructure dosimetry is superior to whole-heart metrics for predicting cardiac events.
• Baseline cardiovascular (CV) risk factors and other cancer therapies contribute to RICD.
• There is a need for integrated models combining CV risk, detailed dosimetry, and biomarkers.

Conclusions:

• A comprehensive framework is needed to predict radiation-induced cardiac disease (RICD).
• Future models should integrate baseline CV risk, cardiac substructure dosimetry, and novel biomarkers.
• This approach will improve cardiac risk mitigation strategies for cancer survivors undergoing radiotherapy.