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IJE Advance Access originally published online on May 1, 2008
International Journal of Epidemiology 2008 37(3):518-523; doi:10.1093/ije/dyn067
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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2008; all rights reserved.

Commentary: A dose–response relationship for radiation-induced heart disease—current issues and future prospects

Paul McGale* and Sarah C Darby

* Corresponding author. Clinical Trial Service Unit, Richard Doll Building, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford OX3 7LF, UK. E-mail: paul.mcgale@ctsu.ox.ac.uk

Accepted 12 March 2008

The first 150 words of the full text of this article appear below.

There is compelling evidence that ionizing radiation can increase the risk of heart disease. An overview of 63 trials including 32 800 women with early breast cancer1 found that the death rate from heart disease in women randomized to radiotherapy was 27% higher than that for women randomized to no radiotherapy (SE 7%, 2p = 0.0001). Irradiated women in these trials received 1–20 Gy mean cardiac dose,2 depending on the technique used and the laterality of the tumour, typically in about 20 fractions.

Breast cancer radiotherapy techniques have changed since many of the women in these trials were irradiated and mean cardiac doses have reduced. However, the heart still usually receives some dose. A detailed study of cardiac doses from adjuvant tangential breast cancer radiotherapy in 2006 in a major UK radiotherapy centre found that about half the women with left-sided tumours received doses of 20 Gy or more . . . [Full Text of this Article]


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