Vandendorpe B, Servagi Vernat S, Ramiandrisoa F, Bazire L, Kirova Y M
Département de radiothérapie, institut de cancérologie Jean-Godinot, 1, rue du Général-Koenig, 51100 Reims, France.
Département de radiothérapie, institut de cancérologie Jean-Godinot, 1, rue du Général-Koenig, 51100 Reims, France.
Cancer Radiother. 2017 Oct;21(6-7):626-635. doi: 10.1016/j.canrad.2017.07.044. Epub 2017 Sep 1.
Radiation therapy of breast cancer, Hodgkin lymphoma, lung cancer and others thoracic irradiations induce an ionizing radiation dose to the heart. Irradiation of the heart, associated with patient cardiovascular risk and cancer treatment-induced cardiotoxicity, increase cardiovascular mortality. The long survival after breast or Hodgkin lymphoma irradiation requires watching carefully late treatment toxicity. The over-risk of cardiac events is related to the dose received by the heart and the irradiated cardiac volume. The limitation of cardiac irradiation should be a priority in the planning of thoracic irradiations. Practices have to be modified, using modern techniques to approach of the primary objective of radiotherapy which is to optimize the dose to the target volume, sparing healthy tissues, in this case the heart. We have reviewed the literature on cardiac toxicity induced by conformational tridimensional radiation therapy, intensity-modulated radiation therapy or stereotactic body radiation therapy, in order to evaluate the possibilities to limit cardiotoxicity. Finally, we summarise the recommendations on dose constraints to the heart and coronary arteries.
乳腺癌、霍奇金淋巴瘤、肺癌及其他胸部放疗会使心脏受到电离辐射剂量。心脏照射与患者心血管风险及癌症治疗引起的心脏毒性相关，会增加心血管死亡率。乳腺癌或霍奇金淋巴瘤放疗后的长期生存需要密切关注晚期治疗毒性。心脏事件的额外风险与心脏接受的剂量及照射的心脏体积有关。在胸部放疗计划中，限制心脏照射应是首要任务。必须改进做法，采用现代技术来实现放射治疗的主要目标，即在这种情况下保护健康组织（心脏）的同时，优化靶体积的剂量。我们回顾了关于三维适形放疗、调强放疗或立体定向体部放疗引起心脏毒性的文献，以评估限制心脏毒性的可能性。最后，我们总结了关于心脏和冠状动脉剂量限制的建议。
