Radiation injury to the heart.
For the RTOG Consensus Conference on Late Effects of Cancer Treatment we summarize the clinical manifestations of cardiac complications appearing months to years following incidental irradiation of the heart during treatment of thoracic neoplasms. The most common effects present as pericardial disease, however, it is becoming more clear that precocious or accelerated coronary artery disease is an important late effect, especially in patients treated with radiation before the age of 21 years. To the extent it is known, the pathophysiology of the various syndromes is described and the extensive literature on dose, volume, and fractionation factors is reviewed. Based upon our current understanding of late cardiac effects, a clinical grading system has been developed and is published elsewhere in this issue.
Stewart
J R
JR
Division of Radiation Oncology, University of Utah Medical Center, Salt Lake City, USA.
Fajardo
L F
LF
Gillette
S M
SM
Constine
L S
LS
D000818:Animals; D009202:Cardiomyopathies / Q000209:etiology / Q000473:pathology; D003327:Coronary Disease / Q000209:etiology; D004307:Dose-Response Relationship, Radiation; D005355:Fibrosis / Q000209:etiology; D006321:Heart / Q000187:drug effects / Q000528:radiation effects*; D006331:Heart Diseases / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D015994:Incidence; D009206:Myocardium / Q000473:pathology; D010496:Pericardium / Q000187:drug effects / Q000528:radiation effects; D011817:Rabbits; D011878:Radiotherapy / Q000009:adverse effects*; D013997:Time Factors