Radiation-induced coronary artery disease: prevention, screening and contemporary management Artykuł przeglądowy
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Abstrakt
Radiotherapy has become an integral component of modern cancer treatment, contributing substantially
to improved survival among patients with thoracic malignancies. However, as the number
of long-term cancer survivors continues to increase, the recognition of late cardiovascular
complications has become an important aspect of survivorship care. Among these complications,
radiation-induced coronary artery disease (RICAD) represents one of the most clinically significant
manifestations of radiation-associated cardiotoxicity, contributing to considerable long-term morbidity
and mortality. The pathogenesis of RICAD is multifactorial and differs from conventional atherosclerosis,
involving radiation-induced endothelial injury, chronic inflammation, oxidative stress, and
progressive vascular fibrosis, ultimately leading to accelerated coronary artery disease. The clinical
presentation is frequently delayed by many years after completion of radiotherapy and may remain
asymptomatic or present with atypical manifestations, making timely diagnosis particularly challenging.
The risk of RICAD is influenced not only by the radiation dose delivered to the heart but also by
patient characteristics, cardiovascular comorbidities, tumour location, and advances in radiotherapy
techniques. As cancer survival continues to improve, identification of high-risk patients, implementation
of appropriate screening strategies, and selection of optimal diagnostic and therapeutic approaches
have become increasingly important in clinical practice. This review summarizes the current
evidence regarding risk factors, screening recommendations, diagnostic evaluation, contemporary
management, and preventive strategies for radiation-induced coronary artery disease.
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Utwór dostępny jest na licencji Creative Commons Uznanie autorstwa – Użycie niekomercyjne 4.0 Międzynarodowe.
Copyright: ? Medical Education sp. z o.o. This is an Open Access article distributed under the terms of the Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). License (https://creativecommons.org/licenses/by-nc/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)
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