title: Radiation-induced cardiovascular disease: impact of dose and volume.
abstract: The radiation-induced cardiovascular pathology represents a major cause of morbidity and mortality in patients undergoing therapeutic chest irradiation. There is a broad range of clinical manifestations probably associated with dose, volume and technique of irradiation. From the assumption that prevention is the best way to manage radiation-induced cardiotoxicity, based on the pathophysiogenesis of heart structures, a number of reports of the literature are reviewed. They consider the incidence of cardiovascular disease in patients affected by Hodgkin's lymphoma and breast cancer. The dosimetric prevention is takled in terms of therapeutic procedures and doses (IMRT, 3DCRT) with particular reference to the impact on cardiotoxicity of parameters as maximum heart distance (MHD), mean lung dose (MLD), normal tissue complication probability (NTCP) and V30. The different evaluation criteria of cardiotoxicity are reported, based on the review of the major scoring scales of acute and late complications, which have been worked out in the course of time (LENT-SOMA, RTOG, CTC v.2.0 and CTC v.3.0). The monitoring system of late toxicity used by the authors is presented.
authors.affiliation: Cattedra di Radioterapia, Università Cattolica del S. Cuore, Policlinico A. Gemelli, Roma, Italy. gmantini@rm.unicatt.it
authors.forename: Giovanna
authors.initials: G
authors.lastname: Mantini
authors.forename: Daniela
authors.initials: D
authors.lastname: Smaniotto
authors.forename: Mario
authors.initials: M
authors.lastname: Balducci
authors.forename: Nicola
authors.initials: N
authors.lastname: Dinapoli
authors.forename: Maura
authors.initials: M
authors.lastname: Campitelli
authors.forename: Barbara
authors.initials: B
authors.lastname: Corvari
authors.forename: Andrea
authors.initials: A
authors.lastname: Simili
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Ciarniello
mesh_terms: D001943:Breast Neoplasms / Q000532:radiotherapy; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000503:physiopathology; D002319:Cardiovascular System / Q000528:radiation effects*; D004307:Dose-Response Relationship, Radiation; D006689:Hodgkin Disease / Q000532:radiotherapy; D006801:Humans; D011829:Radiation Dosage; D011879:Radiotherapy Dosage; D020266:Radiotherapy, Conformal / Q000009:adverse effects*