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BY-NC-ND 3.0 license Open Access Published by De Gruyter Open Access April 17, 2010

Coronary artery disease associated with radiation therapy

Turgay Celık, Cagdas Yuksel, Sait Demırkol, Atila Iyısoy and Cuneyt Ulutın
From the journal Open Medicine

Abstract

Recent advancements in curative-intent therapies have led to dramatic improvements in breast cancer-specific mortality but at the direct expense of increased risk of cardiovascular-related mortality. The use of radiation therapy has led to significant improvements in survival for patients treated for breast cancer. However, as patients live longer, the potentially serious adverse effects of radiation on the heart have raised concerns. Coronary artery disease following irradiation is encountered rarely but is one of the most devastating treatable complications.In this article we review the cardiac complications associated with radiation therapy.

[1] Chung T. Cardiac effects of radiation therapy for malignancy. In: UpToDate, Rose, BD (ed). UpToDate, Wellesley, 2007 Search in Google Scholar

[2] Lee PJ, Mallik R. Cardiovascular effects of radiation therapy: practical approach to radiation therapy-induced heart disease. Cardiol Rev. 2005; 13: 80–86 http://dx.doi.org/10.1097/01.crd.0000131188.41589.c510.1097/01.crd.0000131188.41589.c5Search in Google Scholar

[3] Cuzick J, Stewart H, Rutqvist L, Houghton J, Edwards R, Redmond C, et al. Cause-specific mortality in long-term survivors of breast cancer who participated in trials of radiotherapy. J Clin Oncol 1994; 12: 447–453 10.1200/JCO.1994.12.3.447Search in Google Scholar

[4] Hooning MJ, Aleman BM, Van Rosmalen AJ, et al. Cause-specific mortality in long-term survivors of breast cancer: A 25-year follow up study. Int J Radiat Oncol Biol Phys 2006; 64: 1081 10.1016/j.ijrobp.2005.10.022Search in Google Scholar

[5] Hancock SL, Tucker MA, Hoppe RT. Factors affecting late mortality from heart disease after treatment of Hodgkin’s disease. JAMA. 1993; 270: 1949–1955 http://dx.doi.org/10.1001/jama.270.16.194910.1001/jama.270.16.1949Search in Google Scholar

[6] Glanzmann C, Huguenin P, Lutolf UM, Maire R, Jenni R, Gumppenberg V. Cardiac lesions after mediastinal irradiation for Hodgkin’s disease. Radiother Oncol. 1994; 30: 43–54 http://dx.doi.org/10.1016/0167-8140(94)90008-610.1016/0167-8140(94)90008-6Search in Google Scholar

[7] Favourable and unfavourable effects on long-term survival of radiotherapy for early breast cancer: an overview of the randomised trials. Early Breast Cancer Trialists’ Collaborative Group. Lancet 2000; 355: 1757–1770 Search in Google Scholar

[8] Early Breast Cancer Trialists’ Collaborative Group: Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: An overview of randomized trials. Lancet 2005; 366: 2087–2106 10.1016/S0140-6736(05)67887-7Search in Google Scholar

[9] Hooning MJ, Botma A, Aleman BM, Baaijens MH, Bartelink H, Klijn JG, et al. Long-term risk of cardiovascular disease in 10-year survivors of breast cancer. J Natl Cancer Inst 2007; 99: 365–375 http://dx.doi.org/10.1093/jnci/djk06410.1093/jnci/djk064Search in Google Scholar

[10] Giordano SH, Kuo YF, Freeman JL, Buchholz TA, Hortobagyi GN, Goodwin JS. Risk of cardiac death after adjuvant radiotherapy for breast cancer. J Natl Cancer Inst 2005; 97: 419–24 http://dx.doi.org/10.1093/jnci/dji06710.1093/jnci/dji067Search in Google Scholar

[11] Marks LB, Yu X, Prosnitz RG, Zhou SM, Hardenbergh PH, Blazing M, et al. The incidence and functional consequences of RT-associated cardiac perfusion defects. Int J Radiat Oncol Biol Phys 2005; 63: 214–223 10.1016/j.ijrobp.2005.01.029Search in Google Scholar

[12] Seddon B, Cook A, Gothard L, Salmon E, Latus K, Underwood SR, Yarnold J. Detection of defects in myocardial perfusion imaging in patients with early breast cancer treated with radiotherapy. Radiother Oncol 2002; 64: 53–63 http://dx.doi.org/10.1016/S0167-8140(02)00133-010.1016/S0167-8140(02)00133-0Search in Google Scholar

[13] Harris EE, Correa C, Hwang WT, Liao J, Litt HI, Ferrari VA, Solin LJ. Late cardiac mortality and morbidity in early-stage breast cancer patients after breast-conservation treatment. J Clin Oncol 2006; 24: 4100–4106 http://dx.doi.org/10.1200/JCO.2005.05.103710.1200/JCO.2005.05.1037Search in Google Scholar

[14] Boivin JF, Hutchison GB, Lubin JH, Mauch P. Coronary artery disease mortality in patients treated for Hodgkin’s disease. Cancer. 1992; 69: 1241–1247 10.1002/cncr.2820690528Search in Google Scholar

[15] Carr ZA, Land CE, Kleinerman RA, Weinstock RW, Stovall M, Griem ML, Mabuchi K. Coronary heart disease after radiotherapy for peptic ulcer disease. Int J Radiat Oncol Biol Phys. 2005; 61: 842–850 10.1016/j.ijrobp.2004.07.708Search in Google Scholar

[16] Beckman, JA, Thakore, A, Kalinowski, BH, Harris JR, Creager MA. Radiation therapy impairs endothelium-dependent vasodilation in humans. J Am Coll Cardiol 2001; 37: 761 http://dx.doi.org/10.1016/S0735-1097(00)01190-610.1016/S0735-1097(00)01190-6Search in Google Scholar

[17] Hendry JH, Akahoshi M, Wang LS, Lipshultz SE, Stewart FA, Trott KR. Radiation-induced cardiovascular injury. Radiat Environ Biophys. 2008; 47: 189–193 http://dx.doi.org/10.1007/s00411-007-0155-710.1007/s00411-007-0155-7Search in Google Scholar

[18] Van der Meeren A, Squiban C, Gourmelon P, Lafont H, Gaugler MH. Differential regulation by IL-4 and IL-10 of radiationinduced IL-6 and IL-8 production and ICAM-1 expression by human endothelial cells. Cytokine 1999; 11: 831–838 http://dx.doi.org/10.1006/cyto.1999.049710.1006/cyto.1999.0497Search in Google Scholar

[19] Verheij M, Dewit LG, Boomgaard MN, Brinkman HJ, van Mourik JA. Ionizing radiation enhances platelet adhesion to the extracellular matrix of human endothelial cells by an increase in the release of von Willebrand factor. Radiat Res 1994; 137: 202–207 http://dx.doi.org/10.2307/357881310.2307/3578813Search in Google Scholar

[20] Stewart FA, Heeneman S, te Poele J, Kruse J, Russel NS, Gijbels M, Daemen M. Ionizing radiation accelerates the development of atherosclerotic lesions in ApoE-/- mice and predisposes to an inflammatory plaque phenotype prone to hemorrhage. Am J Pathol 2006; 168: 649–658 http://dx.doi.org/10.2353/ajpath.2006.05040910.2353/ajpath.2006.050409Search in Google Scholar

[21] Eltringham JR, Fajardo LF, Stewart JR. Adriamycin cardiomyopathy: enhanced cardiac damage in rabbits with combined drug and cardiac irradiation. Radiology 1975; 115: 471–472 10.1148/115.2.471Search in Google Scholar

[22] Dalloz F, Maingon P, Cottin Y, Briot F, Horiot JC, Rochette L. Effects of combined irradiation and doxorubicin treatment on cardiac function and antioxidant defenses in the rat. Free Radic Biol Med. 1999; 26: 785–800 http://dx.doi.org/10.1016/S0891-5849(98)00259-710.1016/S0891-5849(98)00259-7Search in Google Scholar

Published Online: 2010-4-17
Published in Print: 2010-4-1

© 2009 Versita Warsaw

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

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