Journal of Clinical Oncology, Vol 8, 741-750, Copyright © 1990 by American Society of Clinical Oncology

ARTICLES

Irradiation-related ischemic heart disease

BW Corn, BJ Trock and RL Goodman
Department of Radiation Oncology, University of Pennsylvania School of Medicine, Philadelphia 19104-4283.

An expectation for long-term survival has emerged among several groups of cancer patients treated with therapeutic irradiation (eg, Hodgkin's disease, early stage breast cancer). Therefore, the cardiovascular sequelae of thoracic irradiation have recently come under scrutiny. Animal models have demonstrated that cardiac irradiation can directly damage the myocardial microvasculature and can indirectly damage the coronary macrovasculature when coupled with cholesterol feeding. A clear association between thoracic radiotherapy and ischemic heart disease was observed among older clinical studies using radiotherapeutic techniques that are no longer optimal by today's standards. Such a relationship could not be confirmed in modern studies in which treatment factors (such as dose and volume of heart irradiated) were more carefully controlled.
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