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Review
. 2024 Jan-Dec:23:15330338241301211.
doi: 10.1177/15330338241301211.

Narrative Review: Cardiotoxicities and Cardiac-Sparing Techniques in Radiotherapy

Maria F Chan  1 , Dhwani Parikh  2 , Chengyu Shi  3
Affiliations
Review

Narrative Review: Cardiotoxicities and Cardiac-Sparing Techniques in Radiotherapy

Maria F Chan et al. Technol Cancer Res Treat. 2024 Jan-Dec.

Abstract

This review article aims to synthesize existing data on radiation-induced heart diseases in patients undergoing chest radiation therapy and also explores cardiac-sparing techniques to mitigate cardiotoxic effects. We conducted a comprehensive database search to review and consolidate data regarding chest radiotherapy and effects on the heart as well as techniques to minimize exposure to the heart. The research findings demonstrate associations between radiation exposure to cardiac substructures and subsequent cardiotoxicity. This review also stresses the importance of identifying patients at high-risk for cardiotoxicity as well as advocates for the adoption of stringent cardiac dose constraints in these patients. Advanced cardiac-sparing techniques, notably respiratory motion management, have emerged as pivotal strategies to minimize the likelihood of cardiac events. This narrative review emphasizes the critical role of these innovations in optimizing cardiac health during radiation treatment.

Keywords: LAD; cardiac sparing; heart; radiation-induced heart diseases; radiotherapy.

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Conflict of interest statement

Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Proton (left), volumetric modulated arc therapy (VMAT) (middle), and three-dimensional conformal radiation therapy (3DCRT) (right) dosimetry for left-sided regional nodal irradiation. Compared with 3DCRT, VMAT decreases left anterior descending artery (LAD) (dark blue) but increases low dose to the heart (pink), resulting in a higher mean heart dose. Proton therapy is often able to minimize both LAD and mean heart dose (red = 50 Gy; yellow = 40 Gy; green = 20 Gy; blue = 5 Gy). Reprinted from with added labels.
Figure 2.
Figure 2.
Motion management workflow and its associated components in radiotherapy. At least one component from each category is selected in the process.
See this image and copyright information in PMC

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