While radiation therapy (RT) is a highly effective treatment for many solid tumors, thoracic RT carries a risk of cardiovascular (CV) morbidity and mortality that limits critical gains in cancer control and survival. High-dose RT has been associated with a significantly increased risk of all-cause mortality, and RT dose to the heart has consistently been associated with the risk of major adverse cardiovascular events and worse survival. Despite the significance of this problem, we have a limited understanding of how RT results in CV toxicity, and the biological and functional mechanisms and predictors of CV toxicity in patients. Fundamental questions include: Which radiation dose-volume parameters are associated with adverse cardiovascular events? Can baseline levels or early changes in biomarkers, imaging measures, and radiation-dose volume parameters identify patients at risk of adverse CV outcomes, and how can we apply this to our patients clinically? Finally, as the field of RT continues to evolve, there is an emerging role for newer applications of non-cancer indications to treat with RT in the heart.

Topics:

1. Introduction
   Carmen Bergom, MD, PhD
2. Radiation Dose Volume Metrics and Cardiac Risk in Adults with Thoracic Malignancies
   Katelyn Atkins, MD, PhD
3. Advances in Radiation Dosimetry Modeling to Define Late Cardiac Effects of Survivors of Childhood Cancer
   Rebecca Howell, PhD, DABR, FAAPM
4. Cardiovascular Management of Patients Prior to, During, and After Radiation Therapy: Modifiable Risk Factors, Imaging and Biomarkers
   Bonnie Ky, MD, MSCE
5. Harnessing Radiation Therapy to Treat Cardiovascular Disease
   Pamela Samson, MD, MPHS
6. Q and A
   Full Panel

This activity is available from March 19, 2024, through 11:59 p.m. Eastern time on March 18, 2026. 

This activity was originally recorded at the 2023 ASTRO Annual Meeting.