Cardiovascular Manifestations From Therapeutic Radiation: A Multidisciplinary Expert Consensus Statement From the International Cardio-Oncology Society

Joshua D. Mitchell, Daniel A. Cehic, Marita Morgia, Carmen Bergom, Joanne Toohey, Patricia A. Guerrero, Maros Ferencik, Robin Kikuchi, Joseph R. Carver, Vlad G. Zaha, Jose A. Alvarez-Cardona, Sebastian Szmit, Andrés J. Daniele, Juan Lopez-Mattei, Lili Zhang, Jörg Herrmann, Anju Nohria, Daniel J. Lenihan, Susan F. Dent

Research output: Contribution to journalReview articlepeer-review

16 Scopus citations

Abstract

Radiation therapy is a cornerstone of cancer therapy, with >50% of patients undergoing therapeutic radiation. As a result of widespread use and improved survival, there is increasing focus on the potential long-term effects of ionizing radiation, especially cardiovascular toxicity. Radiation therapy can lead to atherosclerosis of the vasculature as well as valvular, myocardial, and pericardial dysfunction. We present a consensus statement from the International Cardio-Oncology Society based on general principles of radiotherapy delivery and cardiovascular risk assessment and risk mitigation in this population. Anatomical-based recommendations for cardiovascular management and follow-up are provided, and a priority is given to the early detection of atherosclerotic vascular disease on imaging to help guide preventive therapy. Unique management considerations in radiation-induced cardiovascular disease are also discussed. Recommendations are based on the most current literature and represent a unanimous consensus by the multidisciplinary expert panel.

Original languageEnglish
Pages (from-to)360-380
Number of pages21
JournalJACC: CardioOncology
Volume3
Issue number3
DOIs
StatePublished - Sep 2021

Keywords

  • cancer
  • cardiovascular disease
  • imaging
  • prevention
  • radiation therapy
  • screening

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