Department of Radiation Oncology, Washington University in St. Louis, St. Louis, MO, United States.
Division of Cardiology, Department of Medicine, Washington University in St. Louis, St. Louis, MO, United States.
Kardiol Pol. 2022;80(3):256-265. doi: 10.33963/KP.a2022.0066. Epub 2022 Mar 3.
Radiation-induced cardiac dysfunction is a critical healthcare concern facing survivors of thoracic cancers treated with radiation therapy. Despite cardiac-sparing advances in radiation therapy delivery, many patients with thoracic cancers receiving modern radiation therapy will still have incidental radiation exposure to the heart. Therefore, it is imperative that cardiovascular healthcare providers take appropriate measures to prevent, screen, and manage radiation-induced cardiac dysfunction in patients with a history of thoracic radiation therapy. In this review, we aim to provide healthcare providers with foundational information about radiation-induced cardiac pathophysiology and a chronology of advances in radiation technology. Subsequently, we provide an up-to-date review of treatment- and host-related factors that can influence a patient's risk for radiation-induced cardiac dysfunction. Finally, we culminate our discussion by detailing current screening and management guidelines to aid healthcare providers in caring for their patients with a history of thoracic radiation therapy.
放射性心脏功能障碍是接受放射治疗的胸部癌症幸存者面临的一个关键的医疗保健问题。尽管在放射治疗方面取得了心脏保护方面的进展，但许多接受现代放射治疗的胸部癌症患者仍会偶然受到心脏的放射照射。因此，心血管保健提供者必须采取适当措施，预防、筛查和管理有胸部放射治疗史的患者的放射性心脏功能障碍。在这篇综述中，我们旨在为医疗保健提供者提供有关放射性心脏病理生理学的基础知识和放射技术进展的时间顺序。随后，我们对可影响患者放射性心脏功能障碍风险的治疗和宿主相关因素进行了最新的综述。最后，我们详细介绍了当前的筛查和管理指南，以帮助医疗保健提供者为有胸部放射治疗史的患者提供护理。
