Why the study?
Heart dosimetric parameters are critical for treatment planning, but few data exist on radiosensitivity and dose-volume constraints for specific cardiac structures following mediastinal radiotherapy.
Does mediastinal radiotherapy increase the risk of cardiotoxicity in cancer survivors?
Does mediastinal radiotherapy increase the risk of cardiotoxicity in cancer survivors?
Mediastinal radiotherapy increases the risk of long-term cardiotoxicity in a dose-dependent manner, highlighting the importance of advanced radiation techniques to minimize heart exposure.
Answers are grounded in this paper and cite their sources.
Cardiac dose constraints remain poorly defined for mediastinal radiotherapy; leaves open optimal thresholds to minimize long-term cardiotoxicity.
AIM: To explore available recent literature related to cardiotoxicity following mediastinal radiation. BACKGROUND: Radiotherapy-related heart injury is well documented, with no apparent safety threshold dose. The number of long-term cancer survivors exposed to mediastinal radiotherapy at some point of their treatment is increasing. Heart dosimetric parameters are of great importance in developing a treatment plan, but few data are available regarding radiosensitivity and dose-volume constraints for specific heart structures. MATERIALS AND METHODS: In October 2018, we identified articles published after 1990 through a PubMed/MEDLINE database search. The authors examined rough search results and manuscripts not relevant for the topic were excluded. We extracted clinical outcomes following mediastinal radiotherapy of childhood cancers, lymphoma, medulloblastoma, thymic cancers and hematopoietic cell transplantation survivors and evaluated treatment planning data, whenever available. RESULTS: A total of 1311 manuscripts were identified in our first-round search. Of these manuscripts, only 115 articles, matching our selection criteria, were included. CONCLUSIONS: exceeds 5 Gy. Limited data are available regarding dose-volume predictors for heart substructures and the risk of subsequent cardiac toxicity. An individual patient's cardiotoxicity risk can be modified with advanced treatment planning techniques, including deep inspiration breath hold. Proton therapy is currently showing advantages in improving treatment planning parameters when compared to advanced photon techniques in lymphoma, thymic malignancies, malignant mesothelioma and craniospinal irradiation.
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Ratoša et al. (2019) studied this question.
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