In the 19th of September “Corriere della Sera”, one of the main national journal in Italy, reported an article in the cancer helpdesk column (http://www.corriere.it/salute/sportello_cancro/17_agosto_30/possibile-che-radioterapia-danneggi-valvole-cardiache-a1729a0a-8da8-11e7-9464-bd6d9adf1594.shtml) regarding the hypothesis that radiotherapy can damage heart valves. Dr. Daniela Cardinale, director of the Cardioncology Unit at the European Institute of Oncology, replies that it is possible that radiotherapy, for some types of tumor located near the heart (left breast, lymphoma, etc.), can damage the heart structures, and that the effects can be seen even after years. The article lists general clinical recommendations for these patients in accordance with new scientific evidence.
From the point of view of the Medical Physicist it is important to underline that in the last 20 years the radiation dose has been significantly reduced thanks to the new radiotherapy techniques (modulated intensity radiotherapy, breathing control devices, etc.), capable of minimizing the radiation dose to the heart and consequently the risk of having radiation-induced heart damage.
The Medical Physicist is the professional that accurately estimates the radiation dose absorbed by the various cardiac structures, and provides this data to the radiotherapist, who can make assessments of the probability of cardiac toxicity, in order to obtain the maximum benefit in terms of probability of controlling of the cancer and overall survival and quality of life. These evaluations are made considering the individual clinical situation.
Furthermore, particular attention is paid to the radiotherapy treatment of patients with cardiologist devices (pacemakers and defibrillators) to avoid malfunctions due to radiation. The synergical work of medical physicists, radiotherapists and cardiologists allows safe treatment of these patients too.
Mara Severgnini – University of Trieste Hospital – Department of Medical Physics
