A concise review of irradiation sequelae on the cardiovascular system in pulmonary malignancies

Omer Sager*, Murat Beyzadeoglu, Ferrat Dincoglan, Selcuk Demiral, Bora Uysal, Hakan Gamsiz, Fatih Ozcan, Onurhan Colak and Bahar Dirican

Pulmonary malignancies including Small Cell Lung Cancer (SCLC) and Non-Small Cell Lung Cancer (NSCLC) are frequent cancers and remain to be a leading cause of cancer related mortality worldwide. Radiation Therapy (RT) has an integral role in management of both SCLC and NSCLC. It may be used as the single definitive modality, as part of curative combined modality management, and also for salvage treatment or recurrent disease settings in selected patients. Nevertheless, radiation induced toxicity constitutes an important concern in radiotherapeutic management of pulmonary malignancies. Among the adverse effects of pulmonary irradiation, radiation induced cardiotoxicity deserves utmost consideration. Several studies consistently underscore the importance of minimizing heart exposure as much as possible to avoid untowards cardiac morbidity and mortality.

There have been substantial advances which contributed to improved radiotherapeutic management of SCLC and NSCLC including improved staging and target definition by incorporation of molecular imaging, automatic segmentation procedures, Image Guided Radiation Therapy (IGRT), Breathing Adapted Radiation Therapy (BART), Adaptive Radiation Therapy (ART), Intensity Modulated Radiation Therapy (IMRT). Nevertheless, there is room for further achievements. Proton therapy for management of lung cancer has been suggested as a relatively newer treatment modality with promising results. Unique characteristics of proton therapy may allow for improved cardiac sparing along with reduced integral dose. Future trials are warranted to shed light on contemporary management of pulmonary malignancies with optimal cardiac sparing and reduced irradiation sequelae. Herein, we provide a concise review of irradiation sequelae on the cardiovascular system in pulmonary malignancies.

Keywords:

Published on: Jun 15, 2020 Pages: 79-83

Full Text PDF Full Text HTML DOI: 10.17352/2455-2968.000102
CrossMark Publons Harvard Library HOLLIS Search IT Semantic Scholar Get Citation Base Search Scilit OAI-PMH ResearchGate Academic Microsoft GrowKudos Universite de Paris UW Libraries SJSU King Library SJSU King Library NUS Library McGill DET KGL BIBLiOTEK JCU Discovery Universidad De Lima WorldCat VU on WorldCat