Radiation-related heart disease: current knowledge and future prospects.
Radiation-related heart disease: current knowledge and future prospects.
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DOI：
10.1016/j.ijrobp.2009.09.064
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发表时间：
2010-03-01
影响因子：
7
通讯作者：
Shore, Roy E.
中科院分区：
文献类型：
--
作者：
Darby, Sarah C.;Cutter, David J.;Boerma, Marjan;Constine, Louis S.;Fajardo, Luis F.;Kodama, Kazunori;Mabuchi, Kiyohiko;Marks, Lawrence B.;Mettler, Fred A.;Pierce, Lori J.;Trott, Klaus R.;Yeh, Edward T. H.;Shore, Roy E.
传统上，心脏被认为是一种抗辐射器官，不受心脏剂量低于约30戈瑞的影响。然而，在过去几年中，有几个来源提供的证据表明，低剂量辐射会导致与辐射有关的心脏病。这些研究包括对乳腺癌患者的研究，他们在手术后接受放射治疗时接受的平均心脏剂量为3-17戈瑞，以及对日本原子弹爆炸幸存者的研究，他们接受的剂量高达4戈瑞。在30戈瑞以上的剂量下，与辐射有关的心脏病可能在照射后一年或两年内发生，并且风险随着放射治疗剂量的增加而增加，照射时年龄较小，以及存在常规风险因素。在较低剂量下，典型的潜伏期要长得多，通常超过十年。然而，低剂量后的风险的性质和程度尚未得到很好的描述，目前尚不清楚是否存在一个阈值剂量，低于该阈值剂量就没有风险。关于辐射相关心脏病的证据来自几个不同的学科。本综述汇集了来自病理学、放射生物学、心脏病学、放射肿瘤学和流行病学的信息。它总结了目前的知识，确定了知识的差距，并概述了一些潜在的战略，以填补这些差距。进一步了解辐射相关心脏病的性质和程度将立即应用于放射肿瘤学。它还将为诊断放射学和职业照射的辐射防护政策提供依据。
The heart has traditionally been considered a radio-resistant organ that would be unaffected by cardiac doses below about 30 Gray. During the last few years, however, evidence that radiation-related heart disease can occur following lower doses has emerged from several sources. These include studies of breast cancer patients, who received mean cardiac doses of 3–17 Gray when given radiotherapy following surgery, and studies of survivors of the atomic bombings of Japan who received doses of up to 4 Gray. At doses above 30 Gray, radiation-related heart disease may occur within a year or two of exposure and risk increases with higher radiotherapy dose, younger age at irradiation, and the presence of conventional risk factors. At lower doses the typical latent period is much longer and is often more than a decade. However, the nature and magnitude of the risk following lower doses is not well characterized, and it is not yet clear whether there is a threshold dose below which there is no risk. The evidence regarding radiation-related heart disease comes from several different disciplines. The present review brings together information from pathology, radiobiology, cardiology, radiation oncology and epidemiology. It summarises current knowledge, identifies gaps in that knowledge, and outlines some potential strategies for filling them. Further knowledge about the nature and magnitude of radiation-related heart disease would have immediate application in radiation oncology. It would also provide a basis for radiation protection policies for use in diagnostic radiology and occupational exposure.
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影响因子：
51.1
作者：
Darby, SC;McGale, P;Peto, R
通讯作者：
Peto, R
影响因子：
9.6
作者：
CARLSON, RG;MAYFIELD, WR;ALEXANDER, JA
通讯作者：
ALEXANDER, JA
影响因子：
3.1
作者：
Kruse, JJCM;Strootman, EG;Wondergem, J
通讯作者：
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影响因子：
2.6
作者：
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通讯作者：
Doll, R
影响因子：
5
作者：
Hauptmann, M;Mohan, AK;Mabuchi, K
通讯作者：
Mabuchi, K