Chest Radiation Therapy causes Collateral Damage to the Human Heart

Feeds:: Posts; Comments

« Inactivation of an enzyme needed to metabolize glucose by Vitamic C deprives tumor cells of energy

Harvard Medical School researchers pinpoint enzyme that triggers cell demise in ALS – Blocking enzyme’s activity is the target for patient therapy »

Chest Radiation Therapy causes Collateral Damage to the Human Heart

August 28, 2016 by 2012pharmaceutical

Chest Radiation Therapy causes Collateral Damage to the Human Heart

Reporter: Aviva Lev-Ari, PhD, RN

“Radiation therapy for some forms of cancer involves a large dose of radiation to the chest,” says Milind Desai, MD, Director of Cardiovascular Imaging Research at Cleveland Clinic. “The heart can suffer collateral damage as a result.”

Guideposts for identification

The key to identifying true radiation-associated heart disease, says Dr. Desai, is later injury — whether constrictive pericarditis, coronary artery disease, valvular disease or conduction abnormalities. He adds that the prevalence of radiation-associated heart disease is difficult to ascertain, due in part to its considerable latency, although it appears to be increasing.

Risk factors for radiation-associated heart disease include:

Total radiation dose > 20-35 Gy
Doses > 2 Gy/day
Increased volume of heart irradiated
Younger age
Time since exposure
Concomitant cardiotoxic chemotherapy
Other cardiovascular risk factors (diabetes mellitus, smoking)
Radiation source (cobalt)

SOURCE

Radiation Heart Disease: A Few Learnings on a Diverse, Daunting Entity

Heart Surgery to a Damaged Heart by Radiation

Patients undergoing cardiothoracic surgery at Cleveland Clinic over a three-year period had a 2.5-fold elevated mortality risk if they had a history of malignancy requiring chest irradiation compared with matched controls who underwent the same surgery but did not have a history of malignancy or chest irradiation. Most of the patients with the cancer history had had either

Breast cancer (53 percent) or
Hodgkin lymphoma (27 percent).

Long-Term Survival of Patients With Radiation Heart Disease Undergoing Cardiac Surgery

A Cohort Study

Willis Wu, , , Nicholas G. Smedira, Bruce W. Lytle, Thomas H. Marwick, Brian P. Griffin and Milind Y. Desai

http://dx.doi.org/10.1161/CIRCULATIONAHA.113.001435

Published: April 9, 2013

Alternative treatment approaches, including transcatheter aortic valve replacement or other percutaneous interventions, may be more appropriate after identifying risk.