Cardiac doses in post-operative breast irradiation

Fuller, Sharon; Haybittle, J. L.; Smith, Roy E.; Dobbs, H.J.

doi:10.1016/0167-8140(92)90190-6

Cited by 119 publications

(50 citation statements)

References 12 publications

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“…Radiotherapy for breast cancer can lead to acute and/or late side effects in nearby organs a t risk, eg, the heart, lungs, and brachial plexus (9,64,66,(76)(77)(78). As mentioned above, earlier studies have shown that excessive radiation doses to the heart led to increased cardiovascular mortality in treated patients, particularly those with leftside tumors (7)(8)(9).…”

Section: Side Effectsmentioning

confidence: 99%

“…As mentioned above, earlier studies have shown that excessive radiation doses to the heart led to increased cardiovascular mortality in treated patients, particularly those with leftside tumors (7)(8)(9). Besides the high dose volume in the myocardium, it appears that the use of high, single fractions ( > 2.5 Gy) predisposes patients for late cardiovascular effects (4).…”

Section: Side Effectsmentioning

confidence: 99%

“…The knowledge about the effects of radiotherapy obtained from controlled clinical trials with prolonged followup, obviously addresses the technologies which were available more than 10 to 15 years ago. Since earlier technology has been upgraded-eg, with three-dimensional dose planning-it is clear that the radiotherapy methods used in earlier controlled clinical trials were often inadequate (8,9).…”

Section: Radiotherapy Methodsmentioning

confidence: 99%

“…In some analyses, this resulted in an increased overall mortality in subgroups of patients. particularly those with left-side tumors which, for anatomical reasons, received higher doses to the heart than patients with right-side tumors (7)(8)(9)(64)(65)(66). Studies using modern radiotherapy technology that avoids excessive irradiation dosage have, as mentioned previously, demonstrated a significant reduction in distant metastases and reduced mortality rates from breast cancer (4,5 -that available data from meta-analyses suggest that radiotherapy based on modern technology can reduce the risk of death from the disease (4, 5).…”

Section: Survival; Relapse-free and Totalmentioning

confidence: 99%

See 3 more Smart Citations

Breast Cancer

Rutqvist¹

1996

Acta Oncologica

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Section: Side Effectsmentioning

confidence: 99%

Section: Side Effectsmentioning

confidence: 99%

Section: Radiotherapy Methodsmentioning

confidence: 99%

Section: Survival; Relapse-free and Totalmentioning

confidence: 99%

See 2 more Smart Citations

Breast Cancer

Rutqvist¹

1996

Acta Oncologica

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“…Tangential irradiation of the left breast may encompass up to 10% of the left ventricle. 35,36 With modern megavoltage radiotherapy and increasing access to threedimensional treatment planning and respiratory gated radiotherapy, however, the dose to the heart can be significantly reduced.…”

Section: Morbidity From Breast Radiotherapymentioning

confidence: 99%

A randomised controlled trial of postoperative radiotherapy following breast-conserving surgery in a minimum-risk older population. The PRIME trial

2008

Clinical Governance: An International Journal

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Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per monograph and for the rest of the world £3 per monograph.You can order HTA monographs from our Despatch Agents:-fax (with credit card or official purchase order) -post (with credit card or official purchase order or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you either to pay securely by credit card or to print out your order and then post or fax it. NHS libraries can subscribe free of charge. Public libraries can subscribe at a very reduced cost of £100 for each volume (normally comprising 30-40 titles). The commercial subscription rate is £300 per volume. Please see our website for details. Subscriptions can only be purchased for the current or forthcoming volume. Contact details are as follows: Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to Direct Mail Works Ltd and drawn on a bank with a UK address. Paying by credit cardThe following cards are accepted by phone, fax, post or via the website ordering pages: Delta, Eurocard, Mastercard, Solo, Switch and Visa. We advise against sending credit card details in a plain email. Paying by official purchase orderYou can post or fax these, but they must be from public bodies (i.e. NHS or universities) within the UK. We cannot at present accept purchase orders from commercial companies or from outside the UK. How do I get a copy of HTA on CD?Please use the form on the HTA website (www.hta.ac.uk/htacd.htm). Or contact Direct Mail Works (see contact details above) by email, post, fax or phone. HTA on CD is currently free of charge worldwide.The website also provides information about the HTA Programme and lists the membership of the various committees. HTAA randomised controlled trial of postoperative radiotherapy following breast-conserving surgery in a minimum-risk older population. The PRIME trial NIHR Health Technology Assessment ProgrammeT he Health Technology Assessment (HTA) programme, now part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the costs, effectiveness and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined to include all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care, rather than settings of care. The research findings from the HTA Programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key component of the 'National Knowledge Service'. The HTA Programme is needs-led in that it fills gaps in the evidence needed by the NHS. There are three routes to the start of projects. First is the commissioned r...

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Randomized trial on the effect of radiotherapy in addition to 6 cycles CMF in node-positive breast-cancer patients

Schmoor

Bastert

Dunst³

et al. 2000

Int. J. Cancer

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In 1984 the GBSG started a multicenter randomized trial to compare the effectiveness of 6 cycles of cyclophosphamide, methotrexate and fluorouracil (CMF) with or without radiotherapy (RT) as adjuvant treatment in node‐positive breast‐cancer patients treated by mastectomy. During 5 years, 199 patients were randomized. After a median follow‐up of about 9 years, the treatment groups 6 × CMF and 6 × CMF + RT were compared regarding time to recurrence and death. As the first event of failure, we observed locoregional recurrence in 22 patients, distant metastases in 66 patients, a secondary malignancy in 9 patients and death without previous event in 5 patients. For event‐free survival (EFS), no significant difference was observed [relative risk (RR) 6 × CMF + RT vs. 6 × CMF 0.82, 95% confidence interval (CI) 0.55–1.21]. Event‐specific analysis showed a significant decreased risk after radiotherapy for locoregional recurrence. The risk for distant metastases was estimated as slightly decreased and the risk for secondary malignancy and for death without previous event was estimated as increased in treatment group 6 × CMF + RT in comparison with treatment group 6 × CMF, but these effects were not significant. For overall survival (OS) and breast‐cancer‐specific survival (BCS), no significant treatment effect could be demonstrated. There is a beneficial effect of radiotherapy on locoregional recurrence. For EFS and BCS, a tendency in favour of radiotherapy is observed, but this is not significant; for OS, no difference can be demonstrated, but the power of the study is too low to detect small treatment effects. Int. J. Cancer 86:408–415, 2000. © 2000 Wiley‐Liss, Inc.

show abstract

Cardiac doses in post-operative breast irradiation

Cited by 119 publications

References 12 publications

Breast Cancer

Breast Cancer

A randomised controlled trial of postoperative radiotherapy following breast-conserving surgery in a minimum-risk older population. The PRIME trial

Randomized trial on the effect of radiotherapy in addition to 6 cycles CMF in node-positive breast-cancer patients

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