Keywords:
Breast, Cardiac, Cardiovascular system, CT, Radiation effects, Radiation therapy / Oncology, Treatment effects, Cancer, Multidisciplinary cancer care, Neoplasia
Authors:
N. Stewart, J. Toohey, D. Cehic, P. Purnell, J. Morton, M. Kennedy, J. Dalla Via, Y. Zissiadis
DOI:
10.26044/ranzcr2023/C-133
Purpose
- As cancer treatments and survival outcomes are improving, there is a greater focus on survivorship, prevention and management of late toxicity
- Among cancer survivors alive five years after diagnosis, cardiovascular disease related deaths are shown to exceed cancer related deaths, from 13 years after diagnosis
- Radiation therapy is an integral component of cancer treatment, but radiation dose to the heart is associated with late cardiac toxicity. Accelerated atherosclerosis is an important mechanism in the development of radiation induced cardiac disease.
- Future risk of cardiac disease can be independently predicted in all comers using a coronary artery calcium (CAC) computed tomography (CT) scan, by identifying calcified plaques
- Patients undergoing radiotherapy to the thoracic region undergo a planning CT scan
- This presents an opportunity to use already obtained medical imaging to identify those at greatest risk of future cardiac events
Aim: To investigate the feasibility of using CAC scores from radiotherapy planning CT scans to identify cancer patients at increased risk of cardiac events, and to establish and evaluate a referral pathway for assessment and management in a CardioOncology clinic