Radiation Therapy and Cardiovascular Risk

Radiation continues to play an integral role in the treatment for multiple different tumor types with over 50% of cancer patients receiving radiation during the course of their treatment. Radiation can have long-term impact on cardiac function including accelerated atherosclerosis, valvular dysfunction, conduction abnormalities, and pericardial disease, however recent advances in the delivery of radiation have dramatically reduced the dose given to vascular structures particularly in the treatment of breast cancer. Radiation treatment for other nonbreast malignancies, given their proximities to or involvement with critical vascular structures, often involve much higher doses to both the cardiac and other vascular structures. As more of these patients become long-term survivors from their malignancy, the effects of radiation on the cardiac and vasculature may become more apparent. Thus, to address this we also provide treatment recommendations for patients with a history of radiation in the context of other cardiac risk factors.