Table 2.
Studies investigating the role of CAC and CT coronary angiography in the assessment of CAD in cancer patients.
| Author | No. of patients | Type of cancer | Type of therapy | Mean dose/radiation dose | Risk of developing CAC/CAD |
|---|---|---|---|---|---|
| Coronary artery calcification (CAC) | |||||
| Whitlock et al., J Am Heart Assoc 2015 | 3122 | Different types of cancer vs. no cancer | No therapy | Not applicable | Higher incidence of new CAC in both men and women, even after accounting for CV risk factors |
| Andersen et al., Am J Cardiol 2010 | 47 | Hodgkin lymphoma (HL) | Radiotherapy | 40.6 Gy | Post-irradiation CAC may be a suitable and straightforward method to screen for CAD |
| Chang et al., Front Oncol 2013 | 20 | Breast cancer (left) | Radiotherapy | 4500–5040 cGy | No significant CAC of the coronaries and aorta at 5 or more years following RT |
| Brann et al., Cardio-Oncology 2016 | 83 | All types of cancers | Radiotherapy and/or chemotherapy | Not available | Less prevalent/severe CAC burden after controlling for significant CV risk factors |
| Takx et al., Int J Cardiovasc Imaging 2017 | 333 | Breast cancer | Radiotherapy | 60 Gy | Patients receiving RT had significantly lower the risk of a positive CAC score |
| CT coronary angiography (CTCA) | |||||
| Kupeli et al., J Clin Oncol 2010 | 119 | HL | Radiotherapy and/or chemotherapy | ≥20 Gy | 6.8 times higher in patients receiving mediastinal radiotherapy |
| Girinsky et al., Int J Radiat Oncol Biol Phys 2014 | 179 | HL | Radiotherapy and/or chemotherapy |
Doxorubicin: 330 mg RT: 36 Gy |
CTCA abnormalities were detected in 15% and 34% of patients within the first 5-10 years. |
| Mulrooney et al., Cancer 2014 | 31 | HL | Radiotherapy or multimodality therapy |
RT alone: ≥30 Gy In the Multimodal group RT: 20–29 Gy. Anthracycline: 191 mg/m2 |
CCTA identified CAD in a substantial portion of HL survivors; possible effective screening modality |
| Van Rosendael et al., Radiother Oncol 2017 | 79 | HL and non-HL | Radiotherapy with or without chemotherapy | 36 Gy | Cancer survivors showed a higher presence, greater severity, larger extent, and more proximally located CAD. |
CV, cardiovascular; HL, Hodgkin lymphoma; RT, radiotherapy.