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Cardiotoxicity of Anti-Cancer Radiation Therapy: a Focus on Heart Failure

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Abstract

Purpose of Review

As the percentage of patients achieving long-term survival following treatment of their cancer grows, it is increasingly important to understand the long-term toxicities of cancer-directed treatment. In this review, we highlight the recent findings regarding radiation-induced cardiotoxicity across multiple disease sites, with a particular focus on heart failure.

Recent Findings

Despite its relative lack of study historically, radiation-induced heart failure has now recently been implicated in several studies of breast cancer, lung cancer, esophageal cancer, and lymphoma as a non-trivial potential consequence of thoracic radiotherapy. Data regarding specific cardiac dosimetric endpoints relevant to cardiotoxicity continue to accumulate.

Summary

Radiation-induced heart failure is a rare but significant toxicity of thoracic radiotherapy, that is likely underreported. Important areas for future focus include understanding the interplay between thoracic radiotherapy and concurrent cardiotoxic systemic therapy as well as development of potential mitigation strategies and novel therapeutics.

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Acknowledgements

The authors thank the patients and their families treated at The Ohio State University Comprehensive Cancer Center.

Funding

This work was supported, in part, by National Cancer Institutes (NCI) grant P30 CA016058, and by K23-HL155890 (DA); and by a Robert Wood Johnson Foundation (Harold Amos)-American Heart Association Program grant (DA).

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  1. Daniel Addison and Eric Miller contributed equally to this work.

Authors and Affiliations

  1. Department of Radiation Oncology, The Ohio State University Comprehensive Cancer Center, OH, Columbus, USA

    Alex Ritter & Eric Miller

  2. Cardio-Oncology Program, Division of Cardiology, The Ohio State University Medical Center, Columbus, OH, USA

    Cooper Quartermaine, Jovan Pierre-Charles, Suryakumar Balasubramanian, Pejman Raeisi-Giglou & Daniel Addison

  3. Velammal Medical College Hospital & Research Institute, Madurai, India

    Suryakumar Balasubramanian

  4. Division of Cancer Control, James Cancer Hospital and Solove Research Institute at The Ohio State University, Columbus, OH, USA

    Daniel Addison

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Ritter, A., Quartermaine, C., Pierre-Charles, J. et al. Cardiotoxicity of Anti-Cancer Radiation Therapy: a Focus on Heart Failure. Curr Heart Fail Rep 20, 44–55 (2023). https://doi.org/10.1007/s11897-023-00587-0

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