Dear Farnaz

There are lots of study regarding to the effect of radiotherapy on heart.

I suggest to read this paper:

Radiat Oncol. 2016 Apr 7;11(1):54. doi: 10.1186/s13014-016-0627-5.

Early detection and prediction of cardiotoxicity after radiation therapy for breast cancer: the BACCARAT prospective cohort study.

Jacob S1, Pathak A2, Franck D3, Latorzeff I3, Jimenez G3, Fondard O4, Lapeyre M5, Colombier D5, Bruguiere E5, Lairez O6, Fontenel B7, Milliat F8, Tamarat R9, Broggio D10, Derreumaux S11, Ducassou M3, Ferrières J12, Laurier D13, Benderitter M14, Bernier MO13.

Author information

Abstract

BACKGROUND:

Radiotherapy (RT) for breast cancer presents a benefit in terms of reducing local recurrence and deaths resulting from breast cancer but it can lead to secondary effects due to the presence of neighboring cardiac normal tissues within the irradiation field. Breast RT has been shown to be associated with long-term increased risk of heart failure, coronary artery disease, myocardial infarction and finally cardiovascular death more than 10 years after RT. However, there is still a lack of knowledge for early cardiotoxicity induced by breast RT that can appear long before the onset of clinically significant cardiac events. Based on a 2-year follow-up prospective cohort of patients treated with breast RT, the BACCARAT (BreAst Cancer and CArdiotoxicity Induced by RAdioTherapy) study aims to enhance knowledge on detection and prediction of early subclinical cardiac dysfunction and lesions induced by breast RT and on biological mechanisms potentially involved, based on functional and anatomical cardiac imaging combined with simultaneous assessment of multiple circulating biomarkers and accurate heart dosimetry.

METHODS/DESIGN:

BACCARAT study consists in a monocentric prospective cohort study that will finally include 120 women treated with adjuvant 3D CRT for breast cancer, and followed for 2 years after RT. Women aged 50 to 70 years, treated for breast cancer and for whom adjuvant 3D CRT is indicated, without chemotherapy are eligible for the study. Baseline (before RT) and follow-up data include measurements of functional myocardial dysfunction including strain and strain rate based on 2D-speckle tracking echocardiography, anatomical coronary lesions including description of plaques in segments of coronary arteries based on Coronary computed tomography angiography, and a wide panel of circulating biomarkers. The absorbed dose is evaluated for the whole heart and its substructures, in particular the coronary arteries. Analysis on occurrence and evolution of subclinical cardiac lesions and biomarkers will be performed and completed with dose-response relationship. Multivariate model of normal tissue complication probability (NTCP) will also be proposed.

DISCUSSION:

Tools and results developed in the BACCARAT study should allow improving prediction and prevention of potential lesions to cardiac normal tissues surrounding tumors and ultimately enhance patients' care and quality of life.

TRIAL REGISTRATION:

ClinicalTrials.gov: NCT02605512.

KEYWORDS:

Biomarkers; Breast cancer; Cardiac toxicity; Functional and anatomical cardiac imaging; Heart dosimetry; Radiotherapy

PMID: 27056179 [PubMed - in process] PMCID: PMC4823906 Free PMC Article

I think yu should distingush between radiotherpy forwhich the heart is an organ at risk and radiotherapy where the heart is not an organ at risk. Fr instance radiotherapy for retrosternal lymph nodes versus say radiotheapy for the ovaries.

I should thank members for their opinion.

Breast cancer radiotherapy has been reported to increase risks of heart disease such as ischemic heart disease, pericarditis and valvular disease.

The following papers will be useful.

https://www.ncbi.nlm.nih.gov/pubmed/23484825

https://www.ncbi.nlm.nih.gov/pubmed/21752480

In 2011, the International Commission on Radiological Protection (ICRP) recommended the nominal threshold to the heart and brain for cardio- and celebrovascular disease of both 0.5 Gy independent of the rate of dose delivery.

https://www.researchgate.net/publication/262305338_Emerging_issues_in_radiogenic_cataracts_and_cardiovascular_disease?

Article Emerging issues in radiogenic cataracts and cardiovascular disease