What is the dose response for radiation-induced heart disease in humans and experimental models?
Pericardial tolerance to radiation is defined by specific nominal standard doses, and reirradiation of the thorax carries a high risk of severe cardiac inflammation.
The application of the nominal standard dose (NSD) concept to radiation schedules in Hodgkin's disease and in breast carcinoma following mastectomy has proved useful in defining “pericardial tolerance” as 1,500 rets in large-volume treatments and 1,850 rets in small-volume treatments. The dose response curve for pericardial fibrosis is similar in shape for humans and rabbits. If the heart must be included, reirradiation to tumoricidal doses for recurrence of Hodgkin's disease in the thorax carries an exceedingly high risk of subsequent pericarditis or pancarditis.
Stewart et al. (Sat,) studied this question.