Key result
Higher radiation dose to cardiac substructures and lungs is linked to increased cardiotoxicity and worse survival.
Why the study?
The specific cardiac and pulmonary structures contributing to radiation-induced cardiac toxicities and their impact on survival after thoracic radiotherapy remain incompletely understood and underrecognized.
Does radiation dose to specific cardiac and pulmonary structures correlate with cardiac side effects and survival following thoracic radiotherapy?
Does radiation dose to specific cardiac and pulmonary structures correlate with cardiac side effects and survival following thoracic radiotherapy?
Minimizing radiation-induced cardiac toxicity after thoracic radiotherapy may require targeted sparing of specific cardiac substructures and adjacent organs like the lungs.
Underrecognized cardiac toxicity with incomplete structure-specific risks warrants planning caution; leaves open targeted dosimetric research to guide future constraints.
Radiation dose to the heart is associated with various cardiac side effects. However, the specific cardiac and pulmonary structures that contribute to these toxicities remain incompletely understood. Moreover, although multiple factors contribute to reduced survival after radiotherapy, the role of radiation-induced cardiac toxicity remains underrecognized. This scoping review aimed to evaluate the associations between radiation dose to specific cardiac and pulmonary structures, cardiac side effects, and survival. A total of 137 clinical studies were analysed in accordance with the PRISMA guidelines. Associations between radiation dose and cardiac side effects were identified not only for the whole heart but also for specific cardiac substructures, including myocardial segments, coronary arteries, and the pericardium. Notably, radiation dose to the lungs was also associated with decline in cardiac function, suggesting that minimizing cardiac toxicity may require consideration of both local cardiac irradiation and non-local irradiation of adjacent organs, particularly the lungs. Direct evidence linking cardiac side effects to survival was limited. Nevertheless, the observed associations between higher radiation doses, increased cardiac toxicity, and poorer survival suggest a potential relationship that warrants further investigation. These findings support the hypothesis that reducing specific cardiac side effects may benefit from targeted sparing of the relevant cardiac and pulmonary substructures. While many radiation-related cardiac side effects are now recognized, further research is needed to identify and characterize previously unrecognized manifestations and to clarify their contribution to long-term survival.
No takes yet. Share an insight, caveat, or question.
Fidan et al. (2026) conducted a review in Cardiac side effects following thoracic radiotherapy. Radiation dose to specific cardiac and pulmonary structures was evaluated on Associations between radiation dose to specific structures, cardiac side effects, and survival. A scoping review of 137 clinical studies found that radiation dose to cardiac substructures and the lungs was associated with increased cardiac toxicity and poorer survival.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: