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Cardiac Toxicity
Retrospective review of cardiac doses with all techniques.
1997-2001 Denmark & Sweden
Mean heart dose: Denmark1.6-14.9, Sweden 1.2-22.1
Mean heart dose
L
side 6.6Gy,
R
side2.9Gy
5-14Gy increases risk cardiac toxicity by 15%; >15Gy increases risk by 108%
3 different manifestations of toxicity
1.
Pericarditis
. If >30% received 50Gy. Latency 1yr
2.
Myocardial damage
- lower mean dose. Latency 5yrs
3.
IHD
. Risk continues to increase 10yrs after RT
Chargari et al. Cardiac Toxicity in Breast Cancer Patients
Cancer Treat Rev.
2011
Jun;37(4):321-330.
Feng et al. Development and validation of a heart atlas to study cardiac exposure to
radiation following treatment for breast cacer.
Int J Radiat Oncol Biol Phys.
2011