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Les effets des rayonnements ionisants sur le système cardiovasculaire

Published online by Cambridge University Press:  16 December 2011

F. Milliat ,
M. Benderitter  and
M.-H. Gaugler
F. Milliat
Affiliation:
Institut de radioprotection et de sûreté nucléaire, DRPH, SRBE, Laboratoire de radiopathologie et de thérapies expérimentales (LRTE), Fontenay-aux-Roses, France
M. Benderitter
Affiliation:
Institut de radioprotection et de sûreté nucléaire, DRPH, SRBE, Laboratoire de radiopathologie et de thérapies expérimentales (LRTE), Fontenay-aux-Roses, France
M.-H. Gaugler
Affiliation:
Institut de radioprotection et de sûreté nucléaire, DRPH, SRBE, Laboratoire de radiopathologie et de thérapies expérimentales (LRTE), Fontenay-aux-Roses, France
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Abstract

Le traitement par radiothérapie des cancers des sphères thoracique, médiastinale et ORL est associé à un risque de complications cardiovasculaires. Les patients traités et guéris de leur cancer sont de plus en plus nombreux, vivent de plus en plus longtemps, et leur devenir à long terme doit être pris en considération. Les complications cardiovasculaires associées principalement au traitement des cancers du sein, du lymphome de Hodgkin et des tumeurs de la tête et du cou se manifestent de manière insidieuse et chronique. Leur survenue est liée à de nombreux facteurs comme l’âge du patient au moment du traitement, le nombre d’années suivant la radiothérapie, la dose et le volume au cœur et aux gros vaisseaux (artères coronaires et carotides) ou encore l’association avec les autres facteurs de risque cardiovasculaire traditionnels. Les mécanismes physiopathologiques sont mal connus. Même si des similitudes avec l’athérosclérose liée à l’âge sont établies, les spécificités et les particularités de l’athérosclérose radio-induite pour des fortes doses d’irradiation restent à établir. Pour des faibles niveaux d’exposition aux rayonnements ionisants, des études épidémiologiques récentes suggèrent aussi un risque accru de développer des pathologies cardiovasculaires. L’amélioration des connaissances sur les mécanismes lésionnels à l’origine des pathologies cardiovasculaires radio-induites et l’identification plus précise des populations à risque devraient permettre dans le futur une prise en charge plus efficace de ces patients à risque vasculaire.

Keywords

Ionising radiationradiotherapycardiovascular risk
Type
Research Article
Information
Radioprotection , Volume 46 , Issue 4 , October 2011 , pp. 493 - 510
Copyright
© EDP Sciences, 2011

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References

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