Cardiac Complications of Radiation Therapy

Cardiol Clin. 2025 Feb;43(1):129-149. doi: 10.1016/j.ccl.2024.09.007. Epub 2024 Oct 22.

Abstract

Radiation therapy is a critical component in managing many malignancies by improving local control and survival. The benefits of radiation may come at the expense of unintended radiation injury to the surrounding normal tissues, with the heart being one of the most affected organs in thoracic radiation treatments. As cancer survivors live longer, radiation-induced cardiotoxicity (RICT) is now increasingly recognized. In this review, we highlight the spectrum and pathophysiology of RICT. We summarize contemporary recommendations for risk stratification, screening, prevention, and management of RICT. We briefly highlight novel applications for radiation to treat some cardiac conditions such as resistant arrhythmias.

Keywords: Cardio-oncology; Cardiotoxicity; Radiation; Radiotherapy.

Publication types

  • Review

MeSH terms

  • Cardiotoxicity / etiology
  • Global Health
  • Heart Diseases / etiology
  • Humans
  • Neoplasms / radiotherapy
  • Radiation Injuries* / etiology
  • Radiotherapy / adverse effects