The cardiac toxicity of radiotherapy – a review of characteristics, mechanisms, diagnosis, and prevention

Abstract

Purpose

Radiation-induced heart disease (RIHD) is one of the most serious complications of radiotherapy. The purpose of this paper is to review recent researches about cardiac toxicity of radiotherapy in clinical characteristics, mechanisms, diagnosis, and prevention.

Conclusions

Powered by the rapid development of medicine, the overall survival (OS) of cancer has been improved significantly. Surgery, chemotherapy, and radiotherapy (RT) are three critical ways in the comprehensive treatments of cancer. There is a consensus that early diagnosis and interventions for the prevention of RIHD are crucial. This review concludes recent clinical and experimental studies on RIHD. RIHD, a heterogeneous and serious disease, is a spectrum of heart disease including myocardial disease, pericarditis, coronary artery disease, valvular heart disease, and conduction system dysfunction. Mean heart dose, biomarkers, and detecting techniques are important components in detecting heart injury. Improvements in radiotherapy regimens remain the primary goal of prevention. Further investigation is needed beyond the observation period of most of these studies.

Keywords:

• Neoplasms
• cardiotoxicity
• adverse effects
• radiotherapy
• antitumor therapies

Ethical approval

Written informed consent for publication was obtained from all participants.

Author contributions

All authors have equal contribution to the design and writing of the review. All authors approved the final version of the article.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the Special fund for Taishan Scholar Project [N0.ts20190973], National Natural Science Foundation of China [No. 81773228, 81572958, and 81602007], Science Foundation of Shandong Province [No. ZR2016HB68], and Nanshan Project of Yan-tai for Shandong University [No. 2014QLKY31].

Notes on contributors

Tianhui Wei

Tianhui Wei is a Master of Radiation Oncology and a Researcher at the Department of Radiation Oncology, Shandong University, Shandong, China.

Yufeng Cheng

Yufeng Cheng, PhD, is a Professor of Radiation Oncology and a Senior Researcher at the Department of Radiation Oncology, Qilu Hospital, Shandong University, Shandong, China.