Overview of cardiac toxicity from radiation therapy.

IF 2.2 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Vicky Chin, Robert N Finnegan, Paul Keall, James Otton, Geoff P Delaney, Shalini K Vinod
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引用次数: 0

Abstract

Radiotherapy is an essential part of treatment for many patients with thoracic cancers. However, proximity of the heart to tumour targets can lead to cardiac side effects, with studies demonstrating link between cardiac radiation dose and adverse outcomes. Although reducing cardiac dose can reduce associated risks, most cardiac constraint recommendations in clinical use are generally based on dose to the whole heart, as dose assessment at cardiac substructure levels on individual patients has been limited historically. Furthermore, estimation of an individual's cardiac risk is complex and multifactorial, which includes radiation dose alongside baseline risk factors, and the impact of systemic therapies. This review gives an overview of the epidemiological impact of cancer and cardiac disease, risk factors contributing to radiation-related cardiotoxicity, the evidence for cardiac side effects and future directions in cardiotoxicity research. A better understanding of the interactions between risk factors, balancing treatment benefit versus toxicity and the ongoing management of cardiac risk is essential for optimal clinical care. The emerging field of cardio-oncology is thus a multidisciplinary collaborative effort to enable better understanding of cardiac risks and outcomes for better-informed patient management decisions.

放疗的心脏毒性概述。
放疗是许多胸部癌症患者治疗的重要组成部分。然而,心脏靠近肿瘤靶点可能会导致心脏副作用,有研究表明心脏放射剂量与不良后果之间存在联系。虽然减少心脏剂量可以降低相关风险,但临床上使用的大多数心脏限制建议一般都是基于整个心脏的剂量,因为对单个患者心脏亚结构水平的剂量评估历来有限。此外,对个体心脏风险的评估是复杂的、多因素的,其中包括辐射剂量、基线风险因素和系统疗法的影响。本综述概述了癌症和心脏病的流行病学影响、导致辐射相关心脏毒性的风险因素、心脏副作用的证据以及心脏毒性研究的未来方向。更好地了解风险因素之间的相互作用、平衡治疗效益与毒性以及持续管理心脏风险对于优化临床治疗至关重要。因此,新兴的心脏肿瘤学领域是一个多学科合作的领域,目的是更好地了解心脏风险和结果,从而做出更明智的患者管理决策。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.30
自引率
6.20%
发文量
133
审稿时长
6-12 weeks
期刊介绍: Journal of Medical Imaging and Radiation Oncology (formerly Australasian Radiology) is the official journal of The Royal Australian and New Zealand College of Radiologists, publishing articles of scientific excellence in radiology and radiation oncology. Manuscripts are judged on the basis of their contribution of original data and ideas or interpretation. All articles are peer reviewed.
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