The problem of the heart in thoracic irradiation
Advances in radiotherapy have allowed an increased proportion of lung and oesophageal cancer patients to be treated curatively. However, high doses delivered to critical thoracic organs can result in excess patient mortality. Several groups have identified “base of heart” which includes the left atrium to be associated with non-cancer death. Cx43 protein expressing macrophages have been recognised to facilitate electrical conduction in the heart. We aim to investigate the effects of irradiation of the left atrium to:
- identify if a relationship exists between radiation dose (and radiation combined with drugs) and the presence of non-canonical resident cardiac macrophages in the cardiac conduction system.
- prospectively test the effect of radiation (and biological agents) on heart rhythm in a cohort of mice receiving full or partial heart irradiation. Investigate if any imaging biomarkers (fibrosis on cardiac MRI) can be used as surrogates of atrial injury.
- explore the potential correlations between injury to the cardiac conduction system and pulmonary toxicity when using radiation alone or radiation and drug combinations.
- develop translational questions to be tested for patients undergoing chemoradiation for thoracic malignancies and understand potential mechanistic pathways of damage.
Secondary supervision will be provided by Anderson Ryan.