Why the study?
Does thoracic irradiation increase the risk of ischemic heart disease in cancer patients?
Does thoracic irradiation increase the risk of ischemic heart disease in cancer patients?
Modern radiotherapeutic techniques with controlled dose and volume appear to mitigate the previously observed risk of irradiation-related ischemic heart disease.
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Modern radiotherapy techniques may not confer excess ischemic heart disease risk; leaves open need for prospective validation in contemporary cohorts.
An expectation for long-term survival has emerged among several groups of cancer patients treated with therapeutic irradiation (eg, Hodgkin's disease, early stage breast cancer). Therefore, the cardiovascular sequelae of thoracic irradiation have recently come under scrutiny. Animal models have demonstrated that cardiac irradiation can directly damage the myocardial microvasculature and can indirectly damage the coronary macrovasculature when coupled with cholesterol feeding. A clear association between thoracic radiotherapy and ischemic heart disease was observed among older clinical studies using radiotherapeutic techniques that are no longer optimal by today's standards. Such a relationship could not be confirmed in modern studies in which treatment factors (such as dose and volume of heart irradiated) were more carefully controlled.
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Corn et al. (1990) studied this question.
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