Key Points
- To review the underlying biological and vascular mechanisms through which radiation exposure induces cardiovascular and cerebrovascular toxicities in cancer patients.
- Synthesized findings from clinical and experimental studies investigating radiation-induced microvascular and macrovascular damage.
- Evaluated pathophysiological processes including endothelial activation, myocardial perfusion defects, monocyte recruitment, and atherosclerotic plaque formation.
- Radiation induces microvascular inflammatory cascades that cause microthrombi, vessel occlusion, reduced vascular density, focal ischemia, and myocardial fibrosis.
- Left ventricular radiation exposure in breast cancer radiotherapy directly correlates with the incidence and extent of regional myocardial perfusion defects.
- Endothelial irradiation upregulates adhesion molecules to recruit monocytes, driving lipid accumulation and generating rupture-prone inflammatory plaques.
Structured PICO
PPopulationCancer patients exposed to radiation therapy
IInterventionRadiation therapy
OOutcomeMechanisms of radiation-induced cardiovascular and cerebrovascular damage
This review highlights that radiation-induced cardiovascular toxicity is driven by microvascular inflammation and accelerated atherosclerosis, emphasizing the need to minimize cardiac exposure during radiotherapy.
Limitations
- Not a comprehensive review of the literature