Technical Prevention of Radiation-induced Cardiovascular Toxicity

Radiotherapy has been an important component of cancer treatment. In the malignancy with long survival, radiation-induced cardiovascular toxicity significantly jeopardize patients' outcome. Despite that its pathophysiological mechanism is not clear yet, many studies have confirmed the positive correlation between cardiovascular involvement dose, irradiated volume and radiation-induced cardiotoxicity. Therefore, reducing cardiovascular involvement dose as well as irradiated volume is the key to cardiac sparing techniques in radiotherapy. Cardiac sparing techniques includes: (1) methods that reduce radiation fields and dose; (2) methods that increase the distance between heart and irradiated fields; (3) new techniques such as intensity modulated radiotherapy and proton therapy. Although researches in dosimetry have showed that cardiac sparing techniques could lower cardiovascular involvement dose and irradiated volume, further validation is needed for curative effect.