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This article reviews key clinical trial evidence from recent years, including studies published up to March 2025, focusing on the short\u2010term and long\u2010term cardiovascular impacts of combination therapies, aiming to provide clinically relevant guidance for decision\u2010making. Current clinical studies indicate relatively low rates of acute cardiac adverse events during the treatment period. However, long\u2010term follow\u2010up data reveal that patients receiving high\u2010dose radiotherapy (cardiac radiation dose \u2265\u200925\u2009Gy) show a significantly increased 10\u2010year risk of cardiovascular events. Emerging evidence suggests that cardiotoxicity exhibits delayed onset characteristics and significant interindividual variability. Therefore, future research should prioritize long\u2010term cardiac monitoring in combined treatment regimens and actively explore effective strategies to mitigate cardiotoxicity risks. Proposed approaches include establishing comprehensive dynamic monitoring systems integrating radiomics and biomarkers, optimizing radiotherapy dosing to minimize cardiac damage, and developing myocardial protective agents, ultimately achieving optimal balance between treatment efficacy and patient safety.<\/jats:p>","DOI":"10.1111\/1759-7714.70298","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T06:30:52Z","timestamp":1779690652000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Impact of Adjuvant Radiotherapy Combined With Targeted or Immunotherapy on the Heart in Breast Cancer"],"prefix":"10.1111","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-3856-7160","authenticated-orcid":false,"given":"Dongmin","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Tianjin Medical University Cancer Institute &amp; Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy  Tianjin Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanling","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Tianjin Medical University Cancer Institute &amp; Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy  Tianjin Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingting","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Tianjin Medical University Cancer Institute &amp; Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy  Tianjin Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haonan","family":"Han","sequence":"additional","affiliation":[{"name":"Hubei Key Laboratory of Tumor Microenvironment and Immunotherapy, College of Basic Medical Sciences China Three Gorges University  Yichang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yajing","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Anesthesia Tianjin Medical University Cancer Institute &amp; Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy  Tianjin Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liming","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Tianjin Medical University Cancer Institute &amp; Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy  Tianjin Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,24]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.19401\/j.cnki.1007\u20103639.2022.10.010"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mds293"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bcp.2022.115209"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41523\u2010023\u201000508\u20103"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/vaccines13040344"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.23.01779"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw211"},{"issue":"6","key":"e_1_2_13_10_1","first-page":"39","article-title":"Cardiotoxicity in Cancer Patients Treated With Chemotherapy: A Systematic Review","volume":"16","author":"Lima M. 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