Exposure of the oesophagus in breast cancer radiotherapy: A systematic review of oesophagus doses published 2010–2020

Duane, F.; Kerr, Alastair G; Wang, Zhe; Darby, Sarah C.; Ntentas, Georgios; Aznar, Marianne C.; Taylor, Carolyn

doi:10.1016/j.radonc.2021.09.032

Cited by 12 publications

(10 citation statements)

References 28 publications

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“…For lung doses, one systematic review included mean whole lung doses (right and left lungs combined) from 218 regimens in 88 studies published during 2010–2015 [20] . For whole oesophagus doses, one systematic review included mean oesophagus doses from 89 regimens in 33 studies published during 2010–2020 [21] . In these reviews, the main determinants of heart, lung and oesophagus dose were regions irradiated and techniques used.…”

Section: Resultsmentioning

confidence: 99%

“…Doses to these organs from typical modern radiotherapy are usually lower than for women irradiated in the past, as radiotherapy can now be delivered more precisely. In addition, organ doses from modern radiotherapy vary substantially according to the regimen used [15] , [20] , [21] . A further complication is that information on incidental heart, lung and oesophagus doses is unavailable in most of the randomised trials of radiotherapy carried out in the past.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Adjuvant and neoadjuvant breast cancer treatments: A systematic review of their effects on mortality

Kerr

Dodwell

McGale

et al. 2022

Cancer Treatment Reviews

Self Cite

135

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Adjuvant and neoadjuvant breast cancer treatments: A systematic review of their effects on mortality

Kerr

Dodwell

McGale

et al. 2022

Cancer Treatment Reviews

Self Cite

135

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“…However, innovative techniques to treat left-sided IMNs with increased conformality have been proposed, such as supero-inferior split elds, deep inspiration breath hold, IMRT, and proton beam therapy [21][22][23] . For example, dosimetry studies have shown that treatment with proton beam therapy reduces the doses to the lungs, heart, and esophagus compared with photon radiotherapy when implementing breast radiation therapy 22,24,25 . Thus, new technologies and their diversion from IMN treatment are still expected.…”

Section: Discussionmentioning

confidence: 99%

Is it beneficial for patients with early breast cancer after mastectomy to receive internal mammary node irradiation? A propensity-matched analysis of a retrospective cohort

Xie,

Gou,

Zhang

2023

Preprint

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Background The association between internal mammary lymph node irradiation (IMNI) and survival in patients with early-stage breast cancer is currently controversial. Objective We examined the effect of IMNI in patients treated with mastectomy and systemic treatment in China. Methods We analyzed women with early-stage breast cancer who underwent mastectomy followed by adjuvant chest wall and regional lymph node irradiation (RNI) from the Breast Cancer Information Management System (BCIMS). We analyzed women with early-stage breast cancer who underwent mastectomy followed by adjuvant chest wall and regional lymph node irradiation (RNI) from the BCIMS. Patients were categorized into two groups: those who received IMNI and those who received no IMNI. Disease-free survival (DFS) was the primary endpoint. Cox proportional hazards models and propensity score-matching methods were used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) and to minimize bias. Results In accordance with the study inclusion and exclusion criteria, a total of 1,015 patients were included, of whom 189 received adjuvant irradiation with IMNI and 826 received no IMNI. After propensity score matching, baseline characteristics were well-balanced between the two groups. During a median follow-up of 8.9 years, patients treated with IMNIfailed to achieve a better DFS (HR, 0.36; 95% CI, 0.13–0.99; P = 0.04) compared with those treated without IMNI after adjusting for confounders. Subtype analysis further showed that there was an elevated association between IMNI and decreased DFS. Conclusion In China, our findings suggest that the inclusion of IMNs in the RNI protocol aftermastectomy has no survival benefit over twenty decades ago and needs to be carefully considered. Randomized studies are required to further confirm the influence of IMNI on prognosis.

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“…Therefore, SPCs were regarded as one of the RT-associated long-term side effects (Mendes et al , 2017; Xie et al ., 2019; Okonogi et al ., 2022). Though controversies still existed, some previous studies had observed independent associations of RT and SPCs in several tumor types, such as breast, esophageal and lung (Duane et al ., 2021; Zareie et al , 2022; van Barele et al ., 2023). Regrettably, previous publications have not involved some common cancer types, such as gynecological cancers, it is unclear whether the risk of SPCs is increased after RT for primary breast cancer patients.…”

Section: Introductionmentioning

confidence: 99%

Association of radiotherapy for stage I–III breast cancer survivors and second primary malignant cancers: a population-based study

Shi,

Liu,

Tian

et al. 2023

European Journal of Cancer Prevention

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Purpose: With life span extending, breast cancer survivors may face the possibility of developing second primary cancers (SPCs). The objective of this research is to investigate the risk factors, risk attribute to radiotherapy and the survivalship for SPCs. Methods: A total of 445 523 breast cancer patients were enrolled from Surveillance, Epidemiology, and End Results database in 2000–2018. The risk factors for SPCs development were confirmed by competing risk model, and then were integrated to the nomogram establishment. The cumulative incidence of SPCs including SBC (second breast cancer), SGC (second gynecological cancer), and SLC (second lung cancer) were estimated. The radiotherapy-associated risk for SPCs were evaluated by Poisson regression in radiotherapy and no-radiotherapy. Propensity score matching was used to reduce possible bias for survival comparison. Results: There were 57.63% patients in radiotherapy. The risk factors for developing SPCs were age, year, race, tumor size, stage, radiotherapy, grade, surgery, and histology. The cumulative incidence of SPCs was 7.75% in no-radiotherapy and 10.33% in radiotherapy. SLC, SBC, and SGC also appeared the similar results. The increased risk of developing SPCs were associated with radiotherapy in majority subgroups. The dynamic radiotherapy-associated risk for SPCs by age slightly increased risk was observed. Regardless radiotherapy or no-radiotherapy, the 10-year overall survival for SBC (radiotherapy: 59.41%; no-radiotherapy: 55.53%) and SGC (radiotherapy: 48.61%; no-radiotherapy: 35.53%) were worse than that among matched patients with only primary cancers. Conclusions: Breast cancer survivors remained a high radiotherapy-associated risk for developing SPCs. The prognosis in radiotherapy was better than in no-radiotherapy for some specific SPCs. Largely attention should be paid to these patients.

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Exposure of the oesophagus in breast cancer radiotherapy: A systematic review of oesophagus doses published 2010–2020

Cited by 12 publications

References 28 publications

Adjuvant and neoadjuvant breast cancer treatments: A systematic review of their effects on mortality

Adjuvant and neoadjuvant breast cancer treatments: A systematic review of their effects on mortality

Is it beneficial for patients with early breast cancer after mastectomy to receive internal mammary node irradiation? A propensity-matched analysis of a retrospective cohort

Association of radiotherapy for stage I–III breast cancer survivors and second primary malignant cancers: a population-based study

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