title: Radiation-induced cardiac damage in early left breast cancer patients: risk factors, biological mechanisms, radiobiology, and dosimetric constraints.
abstract: Today there is general awareness of the potential damage to the heart in left-sided (more than in right-sided) breast cancer radiotherapy (RT). Historical changes in tumor and heart doses are presented here along with the impact of different RT techniques and volumes. Individual and pharmacological risk factors are also examined with respect to radiation damage. The biological mechanisms of harm are only partially understood, such as the radiobiology of heart damage due to the presence of various radiosensitive structures and their topographic heterogeneity. Furthermore, individual variability may expose patients to higher or lower risks of late cardiac damage or death. Damage mechanisms and radiobiological characteristics in heart irradiation are presented in relation to dosimetric and biological parameters.
authors.affiliation: University Institute of Radiation Oncology Policlinico di Bari, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Sardaro
authors.forename: Maria Fonte
authors.initials: MF
authors.lastname: Petruzzelli
authors.forename: Maria Patrizia
authors.initials: MP
authors.lastname: D'Errico
authors.forename: Luca
authors.initials: L
authors.lastname: Grimaldi
authors.forename: Giorgio
authors.initials: G
authors.lastname: Pili
authors.forename: Maurizio
authors.initials: M
authors.lastname: Portaluri
mesh_terms: D001943:Breast Neoplasms / Q000532:radiotherapy*; D005260:Female; D006321:Heart / Q000528:radiation effects*; D006801:Humans; D011836:Radiation Tolerance; D011879:Radiotherapy Dosage; D012307:Risk Factors; D015899:Tomography, Emission-Computed, Single-Photon