Division of Cardiovascular Disease, Cardio-oncology Section, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8086, St Louis, MO 63110, USA.
Department of Radiation Oncology, Washington University School of Medicine, Alvin J. Siteman Cancer Center, Washington University in St. Louis, 4511 Forest Park Avenue, Suite 3106A, St. Louis, MO 63108, USA.
Cardiol Clin. 2025 Feb;43(1):129-149. doi: 10.1016/j.ccl.2024.09.007. Epub 2024 Oct 22.
Radiation therapy is a critical component in managing many malignancies by improving local control and survival. The benefits of radiation may come at the expense of unintended radiation injury to the surrounding normal tissues, with the heart being one of the most affected organs in thoracic radiation treatments. As cancer survivors live longer, radiation-induced cardiotoxicity (RICT) is now increasingly recognized. In this review, we highlight the spectrum and pathophysiology of RICT. We summarize contemporary recommendations for risk stratification, screening, prevention, and management of RICT. We briefly highlight novel applications for radiation to treat some cardiac conditions such as resistant arrhythmias.
放射治疗通过提高局部控制率和生存率,是治疗许多恶性肿瘤的关键组成部分。放射治疗的益处可能是以周围正常组织的意外辐射损伤为代价的,而心脏是胸部放射治疗中受影响最严重的器官之一。随着癌症幸存者寿命的延长,辐射诱导性心脏毒性(RICT)现在越来越受到关注。在这篇综述中,我们强调了 RICT 的范围和病理生理学。我们总结了当代用于 RICT 的风险分层、筛查、预防和管理的建议。我们简要介绍了用于治疗某些心脏疾病(如难治性心律失常)的辐射的新应用。