While the data regarding radiotherapy (RT)-induced cardiovascular disease in lung cancer patients is limited, the cardiotoxic effects of RT have been thoroughly documented in long-term survivors of breast cancer and Hodgkin's disease. Herein we review data illustrating the cardiotoxic effects of thoracic RT in lung and breast cancer patients. Older RT techniques for treating the breast/chest wall and draining lymph nodes resulted in a relatively high dose being delivered to a substantial volume of heart, and convincing evidence exists of excess cardiovascular morbidity and mortality in patients treated with these techniques. While modern RT techniques have reduced radiation exposure to the heart, they have not eliminated it. In patients treated with modern techniques, there are conflicting data regarding the impact of radiation on late cardiovascular morbidity and mortality. Thus, it is prudent to reduce cardiac exposure as much as possible. Techniques to reduce further cardiac exposure (eg, respiratory gating, intensity modulated radiation therapy) are currently under investigation. Further work is needed to quantify the frequency and severity of cardiac injury and develop preventative methods.

中文翻译：

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胸部放射后的心脏毒性。

虽然有关放疗（RT）诱发的肺癌患者心血管疾病的数据有限，但RT的心脏毒性作用已在乳腺癌和霍奇金病的长期幸存者中得到了充分证明。本文中，我们回顾了说明胸部RT对肺癌和乳腺癌患者的心脏毒性作用的数据。用于治疗乳房/胸部壁和引流淋巴结的较旧的RT技术导致将相对较高的剂量输送到相当大的心脏，并且令人信服的证据表明，使用这些技术治疗的患者存在过度的心血管发病率和死亡率。尽管现代RT技术已减少了对心脏的辐射暴露，但并没有消除它。在接受现代技术治疗的患者中，关于放射线对晚期心血管疾病发病率和死亡率的影响存在矛盾的数据。因此，谨慎地尽可能减少心脏暴露。目前正在研究减少进一步心脏暴露的技术（例如呼吸门控，调强放射治疗）。需要进一步的工作来量化心脏损伤的频率和严重程度，并开发预防方法。