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Radiation injury to the heart
J R Stewart1, L F Fajardo, S M Gillette
1Division of Radiation Oncology, University of Utah Medical Center, Salt Lake City, USA.
Summary
Radiation therapy for thoracic cancers can cause long-term heart problems, including pericardial disease and accelerated coronary artery disease, particularly in young patients. A new grading system helps manage these late cardiac effects.
Area of Science:
- Cardiology
- Radiation Oncology
- Oncology
Background:
- Cancer treatments involving radiation to the chest can lead to delayed cardiac complications.
- These effects manifest months to years after initial treatment.
- Understanding these late effects is crucial for patient management.
Purpose of the Study:
- To summarize clinical manifestations of cardiac complications following radiation therapy for thoracic neoplasms.
- To review the pathophysiology, dose, volume, and fractionation factors influencing late cardiac effects.
- To introduce a clinical grading system for late cardiac effects.
Main Methods:
- Review of clinical manifestations of cardiac complications.
- Summary of known pathophysiology of cardiac syndromes.
- Review of existing literature on radiation dose, volume, and fractionation.
- Development of a clinical grading system.
Main Results:
- Pericardial disease is a common late cardiac effect.
- Precocious or accelerated coronary artery disease is a significant late effect, especially in patients irradiated before age 21.
- Pathophysiology and contributing radiation factors are described.
Conclusions:
- Radiation therapy for thoracic neoplasms can cause significant late cardiac effects.
- Accelerated coronary artery disease is a critical concern in younger patients.
- A new clinical grading system is proposed for managing these late effects.