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Les effets des rayonnements ionisants sur le systèmecardiovasculaire

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 ORLest associé à un risque de complications cardiovasculaires. Les patients traités et guérisde leur cancer sont de plus en plus nombreux, vivent de plus en plus longtemps, et leurdevenir à long terme doit être pris en considération. Les complications cardiovasculairesassociées principalement au traitement des cancers du sein, du lymphome de Hodgkin et destumeurs de la tête et du cou se manifestent de manière insidieuse et chronique. Leursurvenue 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 grosvaisseaux (artères coronaires et carotides) ou encore l’association avec les autresfacteurs de risque cardiovasculaire traditionnels. Les mécanismes physiopathologiques sontmal connus. Même si des similitudes avec l’athérosclérose liée à l’âge sont établies, lesspécificités et les particularités de l’athérosclérose radio-induite pour des fortes dosesd’irradiation restent à établir. Pour des faibles niveaux d’exposition aux rayonnementsionisants, des études épidémiologiques récentes suggèrent aussi un risque accru dedévelopper des pathologies cardiovasculaires. L’amélioration des connaissances sur lesmécanismes lésionnels à l’origine des pathologies cardiovasculaires radio-induites etl’identification plus précise des populations à risque devraient permettre dans le futurune 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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