Predicting Radiation-Induced Heart Disease and Survival—Is Location the Key?

Bergom, Carmen; Rayan, David; Brown, Sherry‐Ann

doi:10.1001/jamaoncol.2020.6259

Cited by 5 publications

(3 citation statements)

References 14 publications

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“…While surgical intervention remains the primary treatment for thymic carcinoma, adjuvant radiotherapy is also recommended to mitigate local recurrence and metastasis risks following incomplete or complete resection. However, it is worth noting that vascular damage has been reported in the literature following radiotherapy, and the potential occlusive effect of radiotherapy on coronary arteries, primarily hastening the progression of atherosclerosis [ 2 , 3 ]. Currently, there is a paucity of comprehensive research in the existing literature regarding the radiological characteristics associated with coronary artery injury resulting from radiotherapy.…”

Section: Introductionmentioning

confidence: 99%

Late coronary artery injury following chemoradiotherapy for thymic carcinoma: a case report

Hu,

Wang,

Cui

et al. 2024

BMC Cardiovasc Disord

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Introduction Surgery remains the primary treatment modality for thymic carcinoma, with adjuvant radiotherapy being recommended to effectively mitigate local recurrence and metastasis rates subsequent to incomplete or complete resection. Chemoradiotherapy has the potential to induce coronary artery occlusion, thereby potentially impacting patients’ long-term survival rates. The existing literature currently lacks comprehensive research on the lesion characteristics of coronary artery injury resulting from chemoradiotherapy. Case presentation The male patient, aged 55, was admitted to the hospital due to recurrent chest tightness and pain persisting for one week. Notably, the patient had previously undergone curative resection surgery for thymic carcinoma seven years ago. After the surgical procedure, the patient underwent a course of adjuvant chemotherapy comprising docetaxel and platinum. 11 months later, imaging examination diagnosed tumor recurrence, and concurrent chemoradiotherapy was administered at a total dose of 62 Gy/31F for planning gross target volume (PGTV) and 54 Gy/31F for planning target volume (PTV) with 2 cycles of paclitaxel and cisplatin. Re-admission of the patient occurred after a 7-year interval subsequent to the completion of concurrent chemoradiotherapy, leading to a subsequent diagnosis of acute non-ST segment elevation myocardial infarction. Following administration of antiplatelet, anticoagulant, and anti-myocardial ischemia therapy, coronary angiography revealed the presence of a bifurcation lesion at the distal end of the left main trunk. Intravascular ultrasound (IVUS) examination demonstrated significant negative remodeling of both the main trunk and its branches at the bifurcation site, characterized by minimal atherosclerotic plaque components. Conclusions Chemoradiotherapy may induce damage to endothelial cells, resulting in an inflammatory response. Negative remodeling of blood vessels is likely to occur, primarily characterized by vasoconstriction but with less atherosclerotic plaque burden. Routine stent implantation in negatively remodeled areas may lead to vascular rupture, necessitating intravascular imaging examination.

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Section: Introductionmentioning

confidence: 99%

Late coronary artery injury following chemoradiotherapy for thymic carcinoma: a case report

Hu,

Wang,

Cui

et al. 2024

BMC Cardiovasc Disord

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“…RIHD is mainly observed many years after patients receive thoracic radiotherapy, manifesting as coronary artery disease, ischemic heart disease, pericarditis, conduction defects, and valvular dysfunction [6][7][8]. RIHD can impact prognosis and increase cardiac mortality and has become a challenge in clinical practice [9,10].…”

Section: Introductionmentioning

confidence: 99%

Acetylation of Atp5f1c Mediates Cardiomyocyte Senescence via Metabolic Dysfunction in Radiation-Induced Heart Damage

Zeng

et al. 2022

Oxidative Medicine and Cellular Longevity

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Objective Ionizing radiation (IR) causes cardiac senescence, which eventually manifests as radiation-induced heart damage (RIHD). This study is aimed at exploring the mechanisms underlying IR-induced senescence using acetylation proteomics. Methods Irradiated mouse hearts and H9C2 cells were harvested for senescence detection. Acetylation proteomics was used to investigate alterations in lysine acetylation. Atp5f1c acetylation after IR was verified using coimmunoprecipitation (Co-IP). Atp5f1c lysine 55 site acetylation (Atp5f1c K55-Ac) point mutation plasmids were used to evaluate the influence of Atp5f1c K55-Ac on energy metabolism and cellular senescence. Deacetylation inhibitors, plasmids, and siRNA transfection were used to determine the mechanism of Atp5f1c K55-Ac regulation. Results The mice showed cardiomyocyte and cardiac aging phenotypes after IR. We identified 90 lysine acetylation sites from 70 protein alterations in the heart in response to IR. Hyperacetylated proteins are primarily involved in energy metabolism. Among them, Atp5f1c was hyperacetylated, as confirmed by Co-IP. Atp5f1c K55-Ac decreased ATP enzyme activity and synthesis. Atp5f1c K55 acetylation induced cardiomyocyte senescence, and Sirt4 and Sirt5 regulated Atp5f1c K55 deacetylation. Conclusion Our findings reveal a mechanism of RIHD through which Atp5f1c K55-Ac leads to cardiac aging and Sirt4 or Sirt5 modulates Atp5f1c acetylation. Therefore, the regulation of Atp5f1c K55-Ac might be a potential target for the treatment of RIHD.

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“…13,14,15 Few authors demonstrated that left anterior descending artery doses have more correlation with cardiac toxicity along with the heart mean dose. 14,15,16,17 Different techniques are in use to reduce the heart and lung doses effectively. One among them is DIBH technique.…”

Section: Introductionmentioning

confidence: 99%

Is it advantageous to use deep inspiration breath hold (DIBH) over free breathing for FAST-Forward dose fractionation scheme in treating carcinoma of left-sided breast? A dosimetric study

Nagaraj

Chandrasekaran

2021

J Radiother Pract

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Aim: To study the effect of deep inspiration breath hold (DIBH) on Fast-Forward trial for left-sided breast radiotherapy dosimetrically using tangential field-in-field (FiF), flattening filtered volumetric-modulated arc therapy (FF-VMAT) and flattening filter free volumetric-modulated arc therapy (FFF-VMAT) in comparison with free breathing (FB). Methods: Computed tomography images were acquired on 15 patients with carcinoma of left breast in FB and DIBH. Planning target volume (PTV) and organs at risk were contoured on both image sets. Dose of 26 Gy in five daily fractions was prescribed to PTV. FiF, FF-VMAT and FFF-VMAT plans were created in treatment planning system on both FB and DIBH. PTV V95%, V107%, D0·1 cc, CI and HI, heart V1·5 Gy, V7 Gy, lung left V8 Gy, monitor units (MU) and beam ON time were used for evaluation. Different technique analysis in same breathing condition and FB versus DIBH for same planning technique were performed. Results: Mean of all 15 patients was reported as mean ± 1 standard deviation. PTV V95% was 97·55 ± 0·10 (FiF), 95·75 ± 0·66 (FF-VMAT) and 96·15 ± 0·46 (FFF-VMAT) in FB while 97·34 ± 0·50 (FiF), 96·03 ± 0·71 (FF-VMAT) and 95·86 ± 0·63 (FFF-VMAT) in DIBH. Heart V7 Gy was 8·53 ± 4·26 (FiF), 8·86 ± 2·20 (FF-VMAT) and 9·27 ± 2·46 (FFF-VMAT) in FB while 6·30 ± 2·98 (FiF), 5·23 ± 2·20 (FF-VMAT) and 4·68 ± 2·01 (FFF-VMAT) in DIBH. p-value of heart V7 Gy between FB and DIBH was 0·278 (FiF), 0·009 (FF-VMAT) and 0·003 (FFF-VMAT). Beam ON time for FFF-VMAT was reduced by 65% (FF-VMAT) and 11% (FiF). Conclusion: Conformal dose to PTV was achieved better with VMAT plans. FFF-VMAT was delivered in less time compared to FF-VMAT and FiF for 26 Gy in five fractions. Heart dose can be significantly minimised with DIBH for VMAT plans.

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Predicting Radiation-Induced Heart Disease and Survival—Is Location the Key?

Cited by 5 publications

References 14 publications

Late coronary artery injury following chemoradiotherapy for thymic carcinoma: a case report

Late coronary artery injury following chemoradiotherapy for thymic carcinoma: a case report

Acetylation of Atp5f1c Mediates Cardiomyocyte Senescence via Metabolic Dysfunction in Radiation-Induced Heart Damage

Is it advantageous to use deep inspiration breath hold (DIBH) over free breathing for FAST-Forward dose fractionation scheme in treating carcinoma of left-sided breast? A dosimetric study

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