RADIATION-INJURY TO THE HEART

For the RTOG Consensus Conference on Late Effects of Cancer Treatment we summarize the clinical manifestations of cardiac complications appe aring months to years following incidental irradiation of the heart du ring treatment of thoracic neoplasms. The most common effects present as pericardial disease, however, it is becoming more clear that precoc ious or accelerated coronary artery disease is an important late effec t, especially in patients treated with radiation before the age of 21 years. To the extent it is known, the pathophysiology of the various s yndromes is described and the extensive literature on dose, volume, an d fractionation factors is reviewed. Based upon our current understand ing of late cardiac effects, a clinical grading system has been develo ped and is published elsewhere in this issue.