ATP 2016

Cardiac toxicity and mortality due to RT • No threshold dose for cardiac morbidity and mortality

• 7% increased risk on cardiac toxicity per 1 Gy increase in mean heart dose  ALARA (As Low As Reasonably Achievable)!

• Cardiac risks can differ due to pre-existing cardiac risks: - pre-existing cardiac disease - lifestyle (smoking, obesity)

- comorbidity (diabetes, hypertension, hypercholesterolaemia) - older age - family history of cardiac disease

Darby NEJM 2013, Taylor Clinical Oncol 2015, Barlett Clin Oncol 2013