Cardiac Complications of Radiation Therapy: A Narrative Review of Recent Literature

Radiation therapy is a widely used treatment for cancer, but it can have detrimental effects on the heart, leading to radiotherapy-induced cardiotoxicity. This condition has become an area of increasing concern, especially as cancer treatments continue to evolve. This review aims to explore the recent literature on radiotherapy-induced cardiotoxicity, focusing on the latest research published. The goal is to identify recent advances in understandings of the underlying mechanisms of damage, risk factors, screening modalities, risk stratification, and novel treatment strategies for mitigating radiotherapy-induced cardiotoxicity. A narrative literature review of PubMed articles from the last 3 years was conducted to gather recent research on radiotherapy-induced cardiotoxicity including keywords such as "cardiac complications," "cardiotoxicity," "radiotherapy," and "radiation." This review identifies advances in understanding the mechanisms of cardiac damage, particularly the roles of humoral immunity and endothelial dysfunction. Recent studies have also highlighted key risk factors, including radiation dose, genetic predispositions, underlying cardiovascular conditions, and lifestyle factors. Additionally, the review emphasizes the need for enhanced surveillance and early detection of cardiotoxicity following radiation therapy, proposing a combined approach involving both imaging techniques and biomarker monitoring for more accurate assessment. Novel imaging methods and emerging biomarkers are being explored for their potential in improving detection and risk stratification. This review article also outlines the national guidelines and clinical recommendations for the prevention and management of radiotherapy-related cardiotoxicity. Despite these advancements, there remain significant gaps in understanding the full range of factors contributing to radiotherapy-induced cardiotoxicity, including the genetic contribution and the interaction between radiotherapy and other cancer treatments with regard to their contributions to cardiotoxicity. Additionally, further research is indicated to further elucidate the mechanisms of damage and the significance of biomarker changes relating to cardiotoxicity. Overall, this review underscores the importance of ongoing research to mitigate the cardiovascular risks associated with radiotherapy.