Hancock et al identified patients who died from heart disease following mediastinal irradiation for Hodgkin's disease. The authors are from Stanford University and the National Cancer Institute of NIH.
Patient selection: mediastinal irradiation for Hodgkin's disease
Causes of cardiac death:
(1) acute myocardial infarction from coronary artery disease
(2) radiation pericarditis
(3) radiation pancarditis
(4) congestive heart failure
(5) cardiomyopathy
(6) valvular heart disease
Risk factors for cardiac mortality:
(1) high mediastinal radiation dose (above 30 Gy)
(2) minimal blocking of heart from radiation exposure
(3) young age at irradiation (highest when younger than 20 years of age; lowest when >= 50 years)
(4) increasing duration of time since irradiation (increased risk at 5 or more years, with further increases at 15 and again at 20 years of followup)
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