Cardiotoxicity associated with radiotherapy in breast cancer: A question-based review with current literatures

• Published in: Cancer treatment reviews Vol. 68; pp. 9 - 15
• Main Authors: Zhu, Qian, Kirova, Youlia M., Cao, Lu, Arsene-Henry, Alexandre, Chen, Jiayi
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.07.2018
• Subjects: Breast cancer; Cardiac events; Cardiotoxicity; Mean heart dose; Radiotherapy; Mean heart dose; Breast cancer; Cardiotoxicity; Radiotherapy; Cardiac events
• ISSN: 0305-7372; 1532-1967; 1532-1967
• DOI: 10.1016/j.ctrv.2018.03.008

•Whether a threshold dose could be defined at which optimal therapeutic effects are achieved with minimum toxicity is critical.•Minimizing risk of radiation -induced cardiovascular disease should begin with pre-treatment assessment of patients’ individualized risk.•Balancing dose constraints between high dose region of cardiac substructures and mean heart dose is still the most direct and best strategy to reduce radiation-induced cardiac injury. Radiotherapy is an indispensable unit of multidisciplinary treatment of breast cancer. Although the application of modern techniques has led to a significantly reduction in radiation-induced heart disease, it is still recognized as the leading causes of morbidity and mortality among breast cancer survivors. With the growing number of long-term survivors, it is important to understand the cardiovascular risks associated with radiotherapy. Questions exist regarding the existence or not of a safe radiation threshold dose that the heart (or its substructures) can receive and strategies to minimize risk of radiation. This paper aims to review the current understanding of radiation-induced cardiotoxicity and try to give answers to those unsettled issues based on current literatures.