Radiation-Induced Cardiovascular Toxicity: Mechanisms, Prevention, and Treatment.
Radiation-Induced Cardiovascular Toxicity: Mechanisms, Prevention, and Treatment.
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DOI：
10.1007/s11936-018-0627-x
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发表时间：
2018-03-20
影响因子：
--
通讯作者：
Sarosiek K
中科院分区：
文献类型：
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作者：
Spetz J;Moslehi J;Sarosiek K
电离辐射是一种非常有效的治疗各种恶性肿瘤的方法，但胸部放疗可能导致的心血管（CV）毒性会损害癌症幸存者的长期健康，并可能成为其使用的限制因素。尽管有100多年的成功临床应用，高能光子损伤心脏心肌、心包、血管和瓣膜细胞内关键成分的机制仍不清楚。最近的研究探索了放射治疗对心脏和血管组织的急性和慢性影响，为心脏病的发展和进展提供了新的见解，包括识别和理解年龄和并发症相关的风险因素。然而，从上游信号到纤维化变化的连接的关键问题仍然存在。此外，胸部放疗的进展有助于限制心脏暴露和损伤，但对放疗技术和心脏保护治疗的进一步改进对于降低患者死亡率和发病率是绝对必要的。放射治疗（RT）驱动的CV毒性仍然是癌症幸存者的主要问题，需要更多的研究来确定确切的毒性机制。然而，最近的研究结果提供了有意义的见解，可能有助于改善患者的预后。
Ionizing radiation is a highly effective treatment for a wide range of malignancies, yet the cardiovascular (CV) toxicity that can result from chest radiotherapy impairs the long-term health of cancer survivors and can be a limiting factor for its use. Despite over 100 years of successful clinical use, the mechanisms by which high-energy photons damage critical components within cells of the heart’s myocardium, pericardium, vasculature and valves remain unclear. Recent studies exploring the acute and chronic effects of radiation therapy on cardiac and vascular tissue have provided new insights into the development and progression of heart disease, including the identification and understanding of age- and complication-associated risk factors. However, key questions relating to the connection from upstream signaling to fibrotic changes remain. In addition, advances in the delivery of chest radiotherapy have helped to limit heart exposure and damage, but additional refinements to delivery techniques and cardioprotective therapeutics are absolutely necessary to reduce patient mortality and morbidity. Radiation therapy (RT)-driven CV toxicity remains a major issue for cancer survivors and more research is needed to define the precise mechanisms of toxicity. However, recent findings provide meaningful insights that may help improve patient outcomes.