Cardiovascular sequelae of radiation therapy

Abstract

Radiotherapy (RT) is one of the main therapeutic options for malignancy treatment; nevertheless, RT is not free from side effects, including an increased risk for secondary neoplasms and other organs injury. Cardiovascular complications are the second most frequent fatal post-RT sequelae, which physicians should be aware of and ready to diagnose early and cure. This review therefore aims to examine epidemiology, pathogenesis and clinical dose-correlated manifestations of RT-induced cardiovascular disease. Future perspectives on screening, prevention and treatment are also provided.

Risk of Device Malfunction in Cancer Patients with Implantable Cardiac Device Undergoing Radiotherapy: A Population‐Based Cohort Study

“…10 However, some recent review articles still seem to mostly underline the importance of radiation dose, largely omitting the effect of beam energy. 11,29 In our study, there was a trend of increased risk of malfunctions in ICDs compared to PMs, which goes in line with previous reports that ICDs might be more sensitive to ionizing radiation than PMs. 13,30 Unexpectedly, we observed that device malfunctions were associated with location of the RT fields below the diaphragm.…”

“…The risks associated with photon beam energy are also acknowledged in the recently published Dutch guidelines, in which patients undergoing RT with >10 MV photons are considered at high risk of device malfunction regardless of the dose to the PM/ICD . However, some recent review articles still seem to mostly underline the importance of radiation dose, largely omitting the effect of beam energy …”

Radiation induced atherosclerotic plaque on descending thoracic aorta

“…1d-e-f). One-year follow-up was uneventful.RT is a well-recognized risk factor for cardiovascular disease, ranging from pericarditis and arrhythmias to silent ischemia and vasculopathy [4]. To the best of our knowledge, we are reporting one of the first cases of isolated aortic plaque on the descending thoracic aorta probably associated to breast RT.…”

A mechanistic model for atherosclerosis and its application to the cohort of Mayak workers

“…Ionizing radiation is known to affect the cardiovascular system detrimentally in radiotherapy patients [24, 25]. Recent analyses point to an effect of radiation already for low and medium doses [26–29] but the main biological mechanisms are unknown.…”