Wiedemann Julia, Coppes Robert P, van Luijk Peter
Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
Front Oncol. 2022 Jul 22;12:931023. doi: 10.3389/fonc.2022.931023. eCollection 2022.
Radiotherapy is part of the treatment for many thoracic cancers. During this treatment heart and lung tissue can often receive considerable doses of radiation. Doses to the heart can potentially lead to cardiac effects such as pericarditis and myocardial fibrosis. Common side effects after lung irradiation are pneumonitis and pulmonary fibrosis. It has also been shown that lung irradiation has effects on cardiac function. In a rat model lung irradiation caused remodeling of the pulmonary vasculature increasing resistance of the pulmonary vascular bed, leading to enhanced pulmonary artery pressure, right ventricle hypertrophy and reduced right ventricle performance. Even more pronounced effects are observed when both, lung and heart are irradiated. The effects observed after lung irradiation show striking similarities with symptoms of pulmonary arterial hypertension. In particular, the vascular remodeling in lung tissue seems to have similar underlying features. Here, we discuss the similarities and differences of vascular remodeling observed after thoracic irradiation compared to those in pulmonary arterial hypertension patients and research models. We will also assess how this knowledge of similarities could potentially be translated into interventions which would be beneficial for patients treated for thoracic tumors, where dose to lung tissue is often unavoidable.
放射治疗是许多胸段癌症治疗的一部分。在这种治疗过程中，心脏和肺组织常常会接受相当剂量的辐射。心脏接受的剂量可能会导致诸如心包炎和心肌纤维化等心脏效应。肺部照射后的常见副作用是肺炎和肺纤维化。研究还表明，肺部照射会对心脏功能产生影响。在大鼠模型中，肺部照射导致肺血管系统重塑，增加肺血管床阻力，进而导致肺动脉压升高、右心室肥厚以及右心室功能降低。当肺部和心脏都接受照射时，会观察到更明显的效应。肺部照射后观察到的效应与肺动脉高压的症状有显著相似之处。特别是，肺组织中的血管重塑似乎具有相似的潜在特征。在此，我们讨论胸段照射后观察到的血管重塑与肺动脉高压患者及研究模型中的血管重塑的异同之处。我们还将评估如何将这种相似性的认识转化为对胸段肿瘤患者有益的干预措施，因为在这些患者中，肺组织受照剂量往往不可避免。
