Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, Lisburn Road, Belfast, Northern Ireland; Cancer Centre Belfast City Hospital, Belfast Health & Social Care Trust, Lisburn Road, Belfast, Northern Ireland.
Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, Lisburn Road, Belfast, Northern Ireland.
Radiother Oncol. 2022 Aug;173:19-31. doi: 10.1016/j.radonc.2022.04.030. Epub 2022 May 6.
The effects of radiation on the heart are dependent on dose, fractionation, overall treatment time, and pre-existing cardiovascular pathology. Murine models have played a central role in improving our understanding of the radiation response of the heart yet a wide range of exposure parameters have been used. We evaluated the study design of published murine cardiac irradiation experiments to assess gaps in the literature and to suggest guidance for the harmonisation of future study reporting.
A systematic review of mouse/rat studies published 1981-2021 that examined the effect of radiation on the heart was performed. The protocol was published on PROSPERO (CRD42021238921) and the findings were reported in accordance with the PRISMA guidance. Risk of bias was assessed using the SYRCLE checklist.
159 relevant full-text original articles were reviewed. The heart only was the target volume in 67% of the studies and simulation details were unavailable for 44% studies. Dosimetry methods were reported in 31% studies. The pulmonary effects of whole and partial heart irradiation were reported in 13% studies. Seventy-eight unique dose-fractionation schedules were evaluated. Large heterogeneity was observed in the endpoints measured, and the reporting standards were highly variable.
Current murine models of radiation cardiotoxicity cover a wide range of irradiation configurations and latency periods. There is a lack of evidence describing clinically relevant dose-fractionations, circulating biomarkers and radioprotectants. Recommendations for the consistent reporting of methods and results of in vivo cardiac irradiation studies are made to increase their suitability for informing the design of clinical studies.
辐射对心脏的影响取决于剂量、分割、总治疗时间和预先存在的心血管病理学。鼠模型在提高我们对心脏辐射反应的理解方面发挥了核心作用，但使用了广泛的暴露参数。我们评估了已发表的鼠心脏照射实验的研究设计，以评估文献中的差距，并为未来研究报告的协调提供指导。
对 1981 年至 2021 年发表的检查辐射对心脏影响的鼠/大鼠研究进行了系统评价。该方案在 PROSPERO（CRD42021238921）上发布，并按照 PRISMA 指南报告了研究结果。使用 SYRCLE 清单评估偏倚风险。
共审查了 159 篇相关的全文原始文章。在 67%的研究中，心脏是唯一的靶区，44%的研究未提供模拟细节。31%的研究报告了剂量学方法。13%的研究报告了全心脏和部分心脏照射的肺部效应。评估了 78 个独特的剂量分割方案。所测量的终点存在很大的异质性，报告标准高度可变。
目前的辐射性心脏毒性鼠模型涵盖了广泛的照射配置和潜伏期。缺乏描述临床相关剂量分割、循环生物标志物和放射保护剂的证据。建议对体内心脏照射研究的方法和结果进行一致报告，以提高其对指导临床研究设计的适用性。
