Key result
Left-sided breast cancer radiotherapy is associated with potential late cardiac damage, which is influenced by dosimetric constraints, biological mechanisms, and individual risk factors.
This review highlights the risk factors, biological mechanisms, and dosimetric constraints associated with radiation-induced cardiac damage in patients receiving radiotherapy for left-sided breast cancer.
May inform cardiac monitoring and sparing techniques in left-sided breast radiotherapy; leaves open prospective validation of risk stratification.
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.
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Sardaro et al. (2012) conducted a review in Early left breast cancer. Left-sided breast cancer radiotherapy was evaluated. Left-sided breast cancer radiotherapy is associated with potential late cardiac damage, which is influenced by dosimetric constraints, biological mechanisms, and individual risk factors.
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