Radiotherapy-induced Cardiotoxicity After the Treatment of Pulmonary and Mediastinal Solid Tumors

Thoracic tumors are extremely common and radiotherapy plays an important role in the treatment of
these malignancies. Cardiac radiation exposure which is inevitable during thoracic radiotherapy may
damage the heart muscle, valves, or coronary arteries. If a malignant thoracic disease can be successfully
treated with the contribution of radiotherapy, long-term cardiac toxicity will become a critical factor in
determining survival. Therefore, radiation oncologists have recently focused on efforts to provide local
disease control without causing toxicity. Over time, advances in radiotherapy techniques have made it
possible to significantly limit the dose of cardiac structures while effectively treating the thoracic tumor.
Intensity-modulated radiotherapy techniques are beneficial in reducing the cardiac dose and therefore
cardiac toxicity. Advanced particle radiotherapy applications such as proton therapy have the potential
to improve tumor cell killing efficiency and reduce the risk of cardiac complications. Close and longterm
cooperation between radiation oncologists and cardiologists is important in the follow-up of patients
undergoing thoracic radiotherapy.

Keywords: Cardiotoxicity; lung cancer; thoracic radiotherapy; thoracic sarcomas; thymic tumors