Radiation-induced cardiac substructure damage and dose constraints: a review.

The field of radiation-induced cardiac damage (RIHD) is garnering increasing attention. The application of advanced radiotherapy reduces the cardiac radiation dose. Still, challenges remain in the uneven dose distribution, the different sensitivity among cardiac substructures (CSs), and the delineation of target areas within these substructures. This article encompasses cardiac substructures, including atria and ventricles, coronary arteries, pulmonary vasculars and superior vena cava (SVC), cardiac conduction system, heart valves and heart base. This review will provide better understanding of RIHD as it firstly summarizes dose limitation of CSs, as well as the risk of cardiac toxicities and its impact on survival following the comprehensive search.