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Cardiac toxicity and mortality due to RT
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No threshold dose for cardiac morbidity and mortality
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7% increased risk on cardiac toxicity per 1 Gy increase in mean heart dose
ALARA (As Low As Reasonably Achievable)!
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Cardiac risks can differ due to pre-existing cardiac risks:
- pre-existing cardiac disease
- lifestyle (smoking, obesity)
- comorbidity (diabetes, hypertension, hypercholesterolaemia)
- older age
- family history of cardiac disease
Darby NEJM 2013, Taylor Clinical Oncol 2015, Barlett Clin Oncol 2013