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Radiotherapy-induced heart disease:a review of the literature

Precision Clinical Medicine 2019年第4期2卷 270-282页

作者： Bingwen Zou Julius Philipp Schuster Kerun Niu Qianyi Huang Alexander Rühle Peter Ernst Huber Department of radiation Oncology Heidelberg University HospitalIm Neuenheimer Feld 400Heidelberg 69120Germany Department of Molecular radiation Oncology German Cancer Research CenterIm Neuenheimer Feld 280Heidelberg 69120Germany Heidelberg Institute for radiation Oncology(HIRO)and National Center for radiation Oncology(NCRO) Im Neuenheimer Feld 280Heidelberg 69120Germany

Radiotherapy as one of the four pillars of cancer therapy plays a critical role in the multimodal treatment of thoracic cancers.Due to significant improvements in overall cancer survival,radiotherapy-induced heart disease(RIHD)has become an increasingly recognized adverse reaction which contributes to major radiationassociated toxicities including non-malignant death.This is especially relevant for patients suffering from diseases with excellent prognosis such as breast cancer or Hodgkin’s lymphoma,since RIHD may occur decades after radiotherapy.Preclinical studies have enriched our knowledge of many potential mechanisms by which thoracic radiotherapy induces heart injury.Epidemiological findings in humans reveal that irradiation might increase the risk of cardiac disease at even lower doses than previously assumed.Recent preclinical studies have identified non-invasive methods for evaluation of RIHD.Furthermore,potential options preventing or at least attenuating RIHD have been developed.Ongoing research may enrich our limited knowledge about biological mechanisms of RIHD,identify non-invasive early detection biomarkers and investigate potential treatment options that might attenuate or prevent these unwanted side effects.Here,we present a comprehensive review about the published literature regarding clinical manifestation and pathological alterations in RIHD.Biological mechanisms and treatment options are outlined,and challenges in RIHD treatment are summarized.

关键词： Radiotherapy heart injury thoracic cancer radiation-induced heart injury cancer treatment

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