Guidelines for Complications of Cancer Treatment Vol VIII Part B

incidence of valvular thickening at 10 years after irradiationwas 8% and rose to 45% at 20 years with grade 3 changes in4.1%. Patients who had echocardiograms 1-6 years after abaseline echocardiogram, 8% of patients with normal heartvalves at initial study developed valvular thickening and 37%of those with abnormal valves showed progression of valvularabnormality.Future Directions:Currently available evidence suggests a strong relationshipbetween “Volume of Normal Tissue Irradiated”, “TotalRadiation Dose”, “Fraction Size of Radiation Dose”,“Interaction with Chemotherapeutic Agents”, and “AssociatedCo morbidities” as major factors influencing the developmentand severity of Cardiopulmonary complications associatedwith thoracic irradiation as in Lung cancer, Breast Cancer,Hodgkin’s disease etc. Advanced radiation therapytechnologies like, Intensity Modulated Radiation Therapy(IMRT), Image Guided Radiation Therapy (IGRT), HelicalTomotherapy etc. which primarily aim at reducing the dose tonormal tissues while delivering the intended dose to the targetvolume would help reduce the radiation related adverse effectssignificantly. Optimal dose intensity and sequencing of varioustreatment modalities (Radiotherapy, Chemotherapy, &Surgery) would further reduce the incidence of acute and lateadverse effects of treatment.References:1. Veinot JP, Edwards WD. Pathology of radiation-inducedheart disease: A surgical and autopsy study of 27 cases.Hum Pathol; 27:766–773. (1996)2. Fajardo LF, Stewart JR. Pathogenesis of radiationinducedmyocardial fibrosis. Lab Invest; 29:244–257.(1973)305