{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:41:26Z","timestamp":1792791686577,"version":"4.5.0"},"reference-count":95,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,9,20]],"date-time":"2024-09-20T00:00:00Z","timestamp":1726790400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001171","name":"Cancer Institute NSW","doi-asserted-by":"publisher","award":["2021\/CBG003"],"award-info":[{"award-number":["2021\/CBG003"]}],"id":[{"id":"10.13039\/501100001171","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100013741","name":"Royal Australian and New Zealand College of Radiologists","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100013741","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["2018592"],"award-info":[{"award-number":["2018592"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Med Imag Rad Onc"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Radiotherapy is an essential part of treatment for many patients with thoracic cancers. However, proximity of the heart to tumour targets can lead to cardiac side effects, with studies demonstrating link between cardiac radiation dose and adverse outcomes. Although reducing cardiac dose can reduce associated risks, most cardiac constraint recommendations in clinical use are generally based on dose to the whole heart, as dose assessment at cardiac substructure levels on individual patients has been limited historically. Furthermore, estimation of an individual's cardiac risk is complex and multifactorial, which includes radiation dose alongside baseline risk factors, and the impact of systemic therapies. This review gives an overview of the epidemiological impact of cancer and cardiac disease, risk factors contributing to radiation\u2010related cardiotoxicity, the evidence for cardiac side effects and future directions in cardiotoxicity research. A better understanding of the interactions between risk factors, balancing treatment benefit versus toxicity and the ongoing management of cardiac risk is essential for optimal clinical care. The emerging field of cardio\u2010oncology is thus a multidisciplinary collaborative effort to enable better understanding of cardiac risks and outcomes for better\u2010informed patient management decisions.<\/jats:p>","DOI":"10.1111\/1754-9485.13757","type":"journal-article","created":{"date-parts":[[2024,9,20]],"date-time":"2024-09-20T11:10:15Z","timestamp":1726830615000},"page":"987-1000","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Overview of cardiac toxicity from radiation therapy"],"prefix":"10.1111","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8908-1243","authenticated-orcid":false,"given":"Vicky","family":"Chin","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Liverpool and Macarthur Cancer Therapy Centres  Sydney New South Wales Australia"},{"name":"Image X Institute University of Sydney  Sydney New South Wales Australia"},{"name":"South Western Sydney Clinical School University of New South Wales  Sydney New South Wales Australia"},{"name":"Ingham Institute for Applied Medical Research  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4728-8462","authenticated-orcid":false,"given":"Robert N","family":"Finnegan","sequence":"additional","affiliation":[{"name":"Northern Sydney Cancer Centre Royal North Shore Hospital  Sydney New South Wales Australia"},{"name":"Institute of Medical Physics University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4803-6507","authenticated-orcid":false,"given":"Paul","family":"Keall","sequence":"additional","affiliation":[{"name":"Image X Institute University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5587-4790","authenticated-orcid":false,"given":"James","family":"Otton","sequence":"additional","affiliation":[{"name":"South Western Sydney Clinical School University of New South Wales  Sydney New South Wales Australia"},{"name":"Department of Cardiology Liverpool Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1829-396X","authenticated-orcid":false,"given":"Geoff P","family":"Delaney","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Liverpool and Macarthur Cancer Therapy Centres  Sydney New South Wales Australia"},{"name":"South Western Sydney Clinical School University of New South Wales  Sydney New South Wales Australia"},{"name":"Ingham Institute for Applied Medical Research  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8075-6219","authenticated-orcid":false,"given":"Shalini K","family":"Vinod","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Liverpool and Macarthur Cancer Therapy Centres  Sydney New South Wales Australia"},{"name":"South Western Sydney Clinical School University of New South Wales  Sydney New South Wales Australia"},{"name":"Ingham Institute for Applied Medical Research  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,9,20]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"Australian Institute of Health and Welfare.Cancer data in Australia.2023. [Cited 11 Dec 2023.] Available from URL:https:\/\/www.aihw.gov.au\/reports\/cancer\/cancer\u2010data\u2010in\u2010australia\/contents\/overview\u2010of\u2010cancer\u2010in\u2010australia\u20102023."},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2014.03.024"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2017.11.004"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2018.06.026"},{"key":"e_1_2_8_6_1","unstructured":"Australian Institute of Health and Welfare.Australian Burden of Disease Study 2022. Catalogue number. BOD 37 AIHW Australian Government.2022."},{"key":"e_1_2_8_7_1","unstructured":"Cancer Australia.Breast cancer in Australia statistics.2023. [Cited 11 Dec 2023.] Available from URL:https:\/\/www.canceraustralia.gov.au\/cancer\u2010types\/breast\u2010cancer\/statistics."},{"key":"e_1_2_8_8_1","unstructured":"Cancer Australia.Lung cancer in Australia statistics.2023. [Cited 11 Dec 2023.] Available from URL:https:\/\/www.canceraustralia.gov.au\/cancer\u2010types\/lung\u2010cancer\/statistics."},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(18)30896-9"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1809697"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1709937"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.21.01308"},{"key":"e_1_2_8_13_1","unstructured":"Australian Institute of Health and Welfare.All heart stroke and vascular disease.2023. [Cited 11 Dec 2023.] Available from URL:https:\/\/www.aihw.gov.au\/reports\/heart\u2010stroke\u2010vascular\u2010diseases\/hsvd\u2010facts\/contents\/disease\u2010types."},{"key":"e_1_2_8_14_1","unstructured":"World Health Organization.Cardiovascular diseases (CVDs).2021. [Cited 11 Dec 2023.] Available from URL:https:\/\/www.who.int\/news\u2010room\/fact\u2010sheets\/detail\/cardiovascular\u2010diseases\u2010(cvds)."},{"key":"e_1_2_8_15_1","unstructured":"Australian Institute of Health and Welfare.Coronary heart disease.2023. [Cited 11 Dec 2023.] Available from URL:https:\/\/www.aihw.gov.au\/reports\/heart\u2010stroke\u2010vascular\u2010diseases\/hsvd\u2010facts\/contents\/summary\u2010of\u2010coronary\u2010heart\u2010disease\u2010and\u2010stroke\/coronary\u2010heart\u2010disease."},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1993.11.7.1208"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1993.03510160067031"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(91)90861-B"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.83.1.356"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0195-668X(03)00114-3"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39261.471806.55"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39609.449676.25"},{"key":"e_1_2_8_23_1","unstructured":"Australian Institute of Health and Welfare.Cancer data in Australia. Cancer summary data visualisation.2023. [Cited 12 May 2024.] Available from URL:https:\/\/www.aihw.gov.au\/reports\/cancer\/cancer\u2010data\u2010in\u2010australia\/contents\/summary\u2010dashboard."},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2020.11.002"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaccao.2021.06.007"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdq042"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2017.07.053"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.70.0229"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2017.05.007"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2015.07.2292"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.117.005633"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2006-07-034405"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1080\/10428190802140873"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mds293"},{"issue":"4","key":"e_1_2_8_35_1","article-title":"Trastuzumab containing regimens for early breast cancer","volume":"2021","author":"Moja L","year":"2012","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.69.1378"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2016.09.134"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2021.2939"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.20.00818"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2017.04.017"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cllc.2017.08.002"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctro.2023.100675"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2012.10.016"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.20.00650"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)31145-5"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.14338\/IJPT-20-00010.1"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.2820690528"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0360-3016(96)00295-7"},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djv008"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2015.1180"},{"key":"e_1_2_8_51_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.72.0722"},{"key":"e_1_2_8_52_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2010-04-278796"},{"key":"e_1_2_8_53_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1209825"},{"key":"e_1_2_8_54_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2015.63.4444"},{"key":"e_1_2_8_55_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.71.6142"},{"key":"e_1_2_8_56_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(14)71207-0"},{"key":"e_1_2_8_57_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2018.12.044"},{"key":"e_1_2_8_58_1","volume-title":"Robbins and Cotran Pathologic Basis of Disease","author":"Kumar V","year":"2005"},{"key":"e_1_2_8_59_1","unstructured":"MarksLB ConstineLS AdamsMJ.Cardiotoxicity of radiation therapy for breast cancer and other malignancies. UpToDate 2023. [Cited 25 Dec 2023.] Available from URL:https:\/\/www.uptodate.com.acs.hcn.com.au."},{"key":"e_1_2_8_60_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.121.021686"},{"key":"e_1_2_8_61_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2013.07.005"},{"key":"e_1_2_8_62_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semcdb.2016.01.045"},{"key":"e_1_2_8_63_1","doi-asserted-by":"publisher","DOI":"10.37549\/ARO1226"},{"key":"e_1_2_8_64_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2017.03.026"},{"key":"e_1_2_8_65_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.69.8480"},{"key":"e_1_2_8_66_1","doi-asserted-by":"publisher","DOI":"10.1161\/hc0402.102975"},{"key":"e_1_2_8_67_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2018.09.021"},{"key":"e_1_2_8_68_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2020.09.004"},{"key":"e_1_2_8_69_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13014-019-1234-z"},{"key":"e_1_2_8_70_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2020.06.031"},{"key":"e_1_2_8_71_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2022.4202"},{"key":"e_1_2_8_72_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2020.6332"},{"key":"e_1_2_8_73_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2024.110085"},{"key":"e_1_2_8_74_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2023.01.085"},{"key":"e_1_2_8_75_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clon.2023.11.029"},{"key":"e_1_2_8_76_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2022.11.033"},{"key":"e_1_2_8_77_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2021.03.005"},{"key":"e_1_2_8_78_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2021.12.041"},{"key":"e_1_2_8_79_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2009.10.058"},{"key":"e_1_2_8_80_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2020.06.015"},{"key":"e_1_2_8_81_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2017.01.008"},{"key":"e_1_2_8_82_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prro.2021.02.002"},{"key":"e_1_2_8_83_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2023.109680"},{"key":"e_1_2_8_84_1","doi-asserted-by":"publisher","DOI":"10.1088\/1361-6560\/ab0ea6"},{"key":"e_1_2_8_85_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.phro.2019.11.007"},{"key":"e_1_2_8_86_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2016.11.016"},{"key":"e_1_2_8_87_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2020.09.045"},{"key":"e_1_2_8_88_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2021.10.008"},{"key":"e_1_2_8_89_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.phro.2020.05.009"},{"key":"e_1_2_8_90_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2021.09.009"},{"key":"e_1_2_8_91_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2017.11.012"},{"key":"e_1_2_8_92_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.4829522"},{"key":"e_1_2_8_93_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejmp.2017.07.014"},{"key":"e_1_2_8_94_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2014.11.037"},{"key":"e_1_2_8_95_1","doi-asserted-by":"publisher","DOI":"10.1093\/jrr\/rraa001"},{"key":"e_1_2_8_96_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2017.05.022"}],"container-title":["Journal of Medical Imaging and Radiation Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1754-9485.13757","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T15:42:00Z","timestamp":1739979720000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1754-9485.13757"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,20]]},"references-count":95,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2024,12]]}},"alternative-id":["10.1111\/1754-9485.13757"],"URL":"https:\/\/doi.org\/10.1111\/1754-9485.13757","archive":["Portico"],"relation":{},"ISSN":["1754-9477","1754-9485"],"issn-type":[{"value":"1754-9477","type":"print"},{"value":"1754-9485","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,20]]},"assertion":[{"value":"2024-03-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-08-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}