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MINI REVIEW article

Front. Pharmacol.

Sec. Cardiovascular and Smooth Muscle Pharmacology

This article is part of the Research TopicTargets in Cardio-Oncology: Drug Effects and Mechanisms of ActionView all 23 articles

Research Progress in the Prevention and Treatment of Radiation-Induced Heart Disease

Provisionally accepted
Ye  SunYe Sun1Chenyi  ZhengChenyi Zheng2Lin  LiLin Li1Shenglin  ZhangShenglin Zhang2Jiajuan  GuoJiajuan Guo1*Jincheng  LvJincheng Lv2*
  • 1Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, China
  • 2Jilin University, Changchun, China

The final, formatted version of the article will be published soon.

Radiotherapy (RT) is a cornerstone treatment for thoracic malignancies, but is associated with an increased risk of radiation-induced heart disease (RIHD), a major cause of long-term morbidity and mortality in cancer survivors. Ionizing radiation directly damages cellular components (proteins, lipids, and DNA), disrupts the mitochondrial electron transport chain, and activates enzymes such as NADPH oxidases, this leads to excessive production and accumulation of reactive oxygen species (ROS). Oxidative stress triggers the pro-inflammatory NF-κB pathway, pro-oxidative MAPK branch of IGF-1 signaling, and the pro-fibrotic TGF-β1 pathway. These cascades promote chronic inflammation, endothelial dysfunction, and microvascular damage, leading to myocardial fibrosis and dysfunction. Antioxidant and anti-inflammatory therapies represent a promising approach for the clinical management of RIHD. Preclinical evidence has suggested that statins, angiotensin-converting enzyme inhibitors (ACEIs), and natural antioxidants such as sodium Tanshinone IIA sulfonate mitigate RIHD by scavenging ROS, reducing inflammation, and inhibiting fibrosis. However, further clinical validation of these drugs is required for RIHD. This review highlights the current research status of the known pathophysiological mechanisms of RIHD, and the various treatment strategies used for its prevention and treatment.

Keywords: Inflammation, Oxidative Stress, Radiation-induced heart disease, Radiotherapy, Reactive Oxygen Species

Received: 13 Nov 2025; Accepted: 02 Dec 2025.

Copyright: © 2025 Sun, Zheng, Li, Zhang, Guo and Lv. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Jiajuan Guo
Jincheng Lv

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