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American Radium Society Appropriate Use Criteria on Cardiac Toxicity Prevention and Management After Thoracic

Arya Amini1, Vlad G Zaha2, Eman Hamad3

  • 1City of Hope National Medical Center, Duarte, California.

Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer
|September 23, 2024
PubMed
Summary

New guidelines help prevent and manage cardiac toxicity in patients receiving thoracic radiotherapy. Risk stratification based on comorbidities and radiation exposure guides cardiac screening and specialist referrals.

Keywords:
Cardiac morbidityCardiac mortalityCardiac screeningCardiac toxicityLung cancerRadiation induced heart disease

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Area of Science:

  • Cardiology
  • Radiation Oncology
  • Oncology

Background:

  • The American Radium Society Thoracic Committee addressed the need for cardiac toxicity management in radiotherapy patients.
  • Development of appropriate use criteria for cardiac toxicity prevention and management was initiated.

Purpose of the Study:

  • To establish consensus guidelines for cardiac toxicity prevention, surveillance, and management in patients undergoing thoracic radiotherapy.
  • To stratify patients based on cardiac comorbidities and radiation-related risks.

Main Methods:

  • A systematic literature review was performed.
  • Case variants were developed for patients with thoracic malignancies, considering cardiovascular risk factors and radiation dose exposure.
  • Modified Delphi methodology was employed for consensus building.

Main Results:

  • Six patient variants were evaluated.
  • High-risk patients with cardiac comorbidities require comprehensive cardiac screening (H&P, ECG, imaging, cardiology referral).
  • Low-risk patients without comorbidities need only a baseline H&P; those without comorbidities but high radiation risk need ECG and H&P.

Conclusions:

  • The American Radium Society Thoracic committee developed consensus guidelines for cardiac toxicity management post-thoracic radiotherapy.
  • Guidelines are based on patient cardiac comorbidities and radiation toxicity risk.
  • These criteria aim to optimize cardiac care for radiotherapy patients.