Cardiac radiosensitivity in the era of thoracic chemoradiotherapy and immunotherapy: a scoping review - PubMed
3 days ago
- #immunotherapy
- #chemoradiotherapy
- #cardiac toxicity
- Concurrent chemoradiotherapy followed by immune checkpoint inhibitor (ICI) consolidation is the standard care for unresectable stage III non-small-cell lung cancer (NSCLC).
- Both chemoradiotherapy and ICIs are independently cardiotoxic, and their combined effects remain unclear.
- The review examines chemoradiotherapy-associated and ICI-associated cardiac toxicity separately and evaluates their convergence in combined therapy.
- Key questions addressed include whether ICI adds cardiac risks to chemoradiotherapy and if previous radiotherapy increases cardiac risks with ICI.
- Other questions explore if ICI alters the radiosensitivity of cardiac subregions and how cardiac endpoints should be defined.
- Potential molecular or pharmacological interventions to mitigate toxicity are discussed, along with major risk factors and management strategies.
- Major gaps identified include the need for studies beyond NSCLC, long-term survivorship data, advanced radiotherapy techniques, and the interplay between lymphopenia and cardiotoxicity.
- The convergence of chemoradiotherapy and ICIs represents a new cardiac risk profile, necessitating larger, long-term studies to balance oncological efficacy with cardiovascular safety.