Dose-related cardiac side effects and its impact on survival following thoracic radiotherapy: A scoping review.
- 1Department of Radiation Oncology, University Medical Centre Groningen, Hanzeplein 1, P.O. Box 30001, 9700, RB, Groningen, the Netherlands.
- 2Department of Cardiology, University Medical Centre Groningen, Hanzeplein 1, P.O. Box 30001, 9700, RB, Groningen, the Netherlands.
Abstract
Radiation dose to the heart is associated with various cardiac side effects. However, the specific cardiac and pulmonary structures that contribute to these toxicities remain incompletely understood. Moreover, although multiple factors contribute to reduced survival after radiotherapy, the role of radiation-induced cardiac toxicity remains underrecognized. This scoping review aimed to evaluate the associations between radiation dose to specific cardiac and pulmonary structures, cardiac side effects, and survival. A total of 137 clinical studies were analysed in accordance with the PRISMA guidelines. Associations between radiation dose and cardiac side effects were identified not only for the whole heart but also for specific cardiac substructures, including myocardial segments, coronary arteries, and the pericardium. Notably, radiation dose to the lungs was also associated with decline in cardiac function, suggesting that minimizing cardiac toxicity may require consideration of both local cardiac irradiation and non-local irradiation of adjacent organs, particularly the lungs. Direct evidence linking cardiac side effects to survival was limited. Nevertheless, the observed associations between higher radiation doses, increased cardiac toxicity, and poorer survival suggest a potential relationship that warrants further investigation. These findings support the hypothesis that reducing specific cardiac side effects may benefit from targeted sparing of the relevant cardiac and pulmonary substructures. While many radiation-related cardiac side effects are now recognized, further research is needed to identify and characterize previously unrecognized manifestations and to clarify their contribution to long-term survival.
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BibTeX
@article{fidan2026doserelated,
title = {{Dose-related cardiac side effects and its impact on survival following thoracic radiotherapy: A scoping review.}},
author = {Umut Fidan and Arno C Hessels and Anne P G Crijns and Robin Wijsman and Peter van der Meer and Johannes A Langendijk and Christina T Muijs and Peter van Luijk},
journal = {Clinical and translational radiation oncology},
year = {2026},
month = oct,
doi = {10.1016/j.ctro.2026.101304},
url = {https://europepmc.org/article/MED/42898116},
note = {CC BY},
}
RIS
TY - JOUR
TI - Dose-related cardiac side effects and its impact on survival following thoracic radiotherapy: A scoping review.
AU - Umut Fidan
AU - Arno C Hessels
AU - Anne P G Crijns
AU - Robin Wijsman
AU - Peter van der Meer
AU - Johannes A Langendijk
AU - Christina T Muijs
AU - Peter van Luijk
PY - 2026
DA - 2026/10/06
JO - Clinical and translational radiation oncology
DO - 10.1016/j.ctro.2026.101304
UR - https://europepmc.org/article/MED/42898116
AB - Radiation dose to the heart is associated with various cardiac side effects. However, the specific cardiac and pulmonary structures that contribute to these toxicities remain incompletely understood. Moreover, although multiple factors contribute to reduced survival after radiotherapy, the role of radiation-induced cardiac toxicity remains underrecognized. This scoping review aimed to evaluate the associations between radiation dose to specific cardiac and pulmonary structures, cardiac side effects, and survival. A total of 137 clinical studies were analysed in accordance with the PRISMA guidelines. Associations between radiation dose and cardiac side effects were identified not only for the whole heart but also for specific cardiac substructures, including myocardial segments, coronary arteries, and the pericardium. Notably, radiation dose to the lungs was also associated with decline in cardiac function, suggesting that minimizing cardiac toxicity may require consideration of both local cardiac irradiation and non-local irradiation of adjacent organs, particularly the lungs. Direct evidence linking cardiac side effects to survival was limited. Nevertheless, the observed associations between higher radiation doses, increased cardiac toxicity, and poorer survival suggest a potential relationship that warrants further investigation. These findings support the hypothesis that reducing specific cardiac side effects may benefit from targeted sparing of the relevant cardiac and pulmonary substructures. While many radiation-related cardiac side effects are now recognized, further research is needed to identify and characterize previously unrecognized manifestations and to clarify their contribution to long-term survival.
SN - 2405-6308
ER -