Vascular damage as an underlying mechanism of cardiac and cerebral toxicity in irradiated cancer patients - PubMed (original) (raw)
Review
doi: 10.1667/RR1862.1. Epub 2010 Aug 30.
Affiliations
- PMID: 21128810
- DOI: 10.1667/RR1862.1
Review
Vascular damage as an underlying mechanism of cardiac and cerebral toxicity in irradiated cancer patients
F A Stewart et al. Radiat Res. 2010 Dec.
Abstract
Radiation is an independent risk factor for cardiovascular and cerebrovascular disease in cancer patients. Modern radiotherapy techniques reduce the volume of the heart and major coronary vessels exposed to high doses, but some exposure is often unavoidable. Radiation damage to the myocardium is caused primarily by inflammatory changes in the microvasculature, leading to microthrombi and occlusion of vessels, reduced vascular density, perfusion defects and focal ischemia. This is followed by progressive myocardial cell death and fibrosis. Clinical studies also demonstrate regional perfusion defects in non-symptomatic breast cancer patients after radiotherapy. The incidence and extent of perfusion defects are related to the volume of left ventricle included in the radiation field. Irradiation of endothelial cells lining large vessels also increases expression of inflammatory molecules, leading to adhesion and transmigration of circulating monocytes. In the presence of elevated cholesterol, invading monocytes transform into activated macrophages and form fatty streaks in the intima, thereby initiating the process of atherosclerosis. Experimental studies have shown that radiation predisposes to the formation of inflammatory plaque, which is more likely to rupture and cause a fatal heart attack or stroke. This paper presents a brief overview of the current knowledge on mechanisms for development of radiation-induced cardiovascular and cerebrovascular damage. It does not represent a comprehensive review of the literature, but reference is made to several excellent recent reviews on the topic.
Similar articles
- Mechanisms and dose-response relationships for radiation-induced cardiovascular disease.
Stewart FA. Stewart FA. Ann ICRP. 2012 Oct-Dec;41(3-4):72-9. doi: 10.1016/j.icrp.2012.06.031. Epub 2012 Aug 22. Ann ICRP. 2012. PMID: 23089006 - Radiation-induced cardiovascular diseases: is the epidemiologic evidence compatible with the radiobiologic data?
Schultz-Hector S, Trott KR. Schultz-Hector S, et al. Int J Radiat Oncol Biol Phys. 2007 Jan 1;67(1):10-8. doi: 10.1016/j.ijrobp.2006.08.071. Int J Radiat Oncol Biol Phys. 2007. PMID: 17189062 Review. - Radiation-associated cardiovascular disease: manifestations and management.
Adams MJ, Lipshultz SE, Schwartz C, Fajardo LF, Coen V, Constine LS. Adams MJ, et al. Semin Radiat Oncol. 2003 Jul;13(3):346-56. doi: 10.1016/S1053-4296(03)00026-2. Semin Radiat Oncol. 2003. PMID: 12903022 Review. - Regulation of coronary blood flow during exercise.
Duncker DJ, Bache RJ. Duncker DJ, et al. Physiol Rev. 2008 Jul;88(3):1009-86. doi: 10.1152/physrev.00045.2006. Physiol Rev. 2008. PMID: 18626066 Review. - Stroke and cerebrovascular complications in childhood cancer survivors.
Partap S. Partap S. Semin Pediatr Neurol. 2012 Mar;19(1):18-24. doi: 10.1016/j.spen.2012.02.012. Semin Pediatr Neurol. 2012. PMID: 22641072 Review.
Cited by
- Review of the Protective Mechanism of Curcumin on Cardiovascular Disease.
Yang C, Zhu Q, Chen Y, Ji K, Li S, Wu Q, Pan Q, Li J. Yang C, et al. Drug Des Devel Ther. 2024 Jan 30;18:165-192. doi: 10.2147/DDDT.S445555. eCollection 2024. Drug Des Devel Ther. 2024. PMID: 38312990 Free PMC article. Review. - Ubiquinol attenuates γ-radiation induced coronary and aortic changes via PDGF/p38 MAPK/ICAM-1 related pathway.
El-Sabbagh WA, Fadel NA, El-Hazek RM, Osman AH, Ramadan LA. El-Sabbagh WA, et al. Sci Rep. 2023 Dec 27;13(1):22959. doi: 10.1038/s41598-023-50218-w. Sci Rep. 2023. PMID: 38151557 Free PMC article. - Advances in Screening for Radiation-Associated Cardiotoxicity in Cancer Patients.
Schiffer W, Pedersen LN, Lui M, Bergom C, Mitchell JD. Schiffer W, et al. Curr Cardiol Rep. 2023 Nov;25(11):1589-1600. doi: 10.1007/s11886-023-01971-x. Epub 2023 Oct 5. Curr Cardiol Rep. 2023. PMID: 37796395 Free PMC article. Review. - Modeling and countering the effects of cosmic radiation using bioengineered human tissues.
Tavakol DN, Nash TR, Kim Y, He S, Fleischer S, Graney PL, Brown JA, Liberman M, Tamargo M, Harken A, Ferrando AA, Amundson S, Garty G, Azizi E, Leong KW, Brenner DJ, Vunjak-Novakovic G. Tavakol DN, et al. Biomaterials. 2023 Oct;301:122267. doi: 10.1016/j.biomaterials.2023.122267. Epub 2023 Aug 11. Biomaterials. 2023. PMID: 37633022 Free PMC article. - Dosimetric Evaluation of Cardiac Structures on Left Breast Cancer Radiotherapy: Impact of Movement, Dose Calculation Algorithm and Treatment Technique.
Barnafi Wittwer E, Rippker C, Caprile P, Torres DE, El Far R, Gago-Arias A, Merino T. Barnafi Wittwer E, et al. Cardiol Res. 2023 Aug;14(4):279-290. doi: 10.14740/cr1486. Epub 2023 Jul 12. Cardiol Res. 2023. PMID: 37559707 Free PMC article.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources