Decisions on when to push the boundaries of dose delivered to organs at risk is a defining feature of the art of radiation oncology. When we reach the limits of what we can achieve with conformality, we begin wrestling with underdosing tumor versus overdosing a nearby structure. One aspect that is often lacking, particularly with heart dosimetry, is consideration of the patient’s baseline cardiac risk. Here we have creations and validation of an individualized cardiac risk model!https://www.redjournal.org/article/S0360-3016(25)00155-5/abstract
for patients receiving liver SBRT. In line with what we have recognized for decades, where heart dose can incrementally impact relative risk of future cardiac event, the volume of heart receiving ≥5 Gy appears to matter very little for those at low to moderate baseline risk (based on age, smoking , hypertension and cardiac comorbidities) but quite a lot for those at high baseline risk. Such considerations can help determine when and when not to push the boundaries of heart dose. | Lee, Int J Radiat Oncol Biol Phys 2025
for patients receiving liver SBRT. In line with what we have recognized for decades, where heart dose can incrementally impact relative risk of future cardiac event, the volume of heart receiving ≥5 Gy appears to matter very little for those at low to moderate baseline risk (based on age, smoking , hypertension and cardiac comorbidities) but quite a lot for those at high baseline risk. Such considerations can help determine when and when not to push the boundaries of heart dose. | Lee, Int J Radiat Oncol Biol Phys 2025