Beyond Mean Heart Dose: Cardiac Metrics for the Modern Era

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Publication: International Journal of Radiation Oncology, Biology, Physics

September 01, 2022

Although radiation therapy is a key treatment for patients with breast cancer, the proximity of the heart to the treatment area – especially in patients with left-sided breast cancer – increases the risk of radiation-induced cardiac disease (RIC). Reducing this risk is an important area of continued study for researchers. While mean heart dose remains a key metric used to indicate the risk of a cardiac event following RT, the authors of this article point to several studies to advocate for further research aimed at better understanding which substructures in the heart may be more specifically correlated to RIC (like the left anterior descending artery) and then further studying the threshold for RT on those substructures. Empirical evidence linking the heart’s substructures to RT thresholds and RIC risk – paired with proton therapy technology like pencil-beam scanning – could pave the way for delivering even more precise RT, while reducing the potential risk of RIC in breast cancer patients.