Prospective assessment of radiotherapy‐associated cardiac toxicity in breast cancer patients: Analysis of data 3 to 6 years after treatment

Prosnitz, Robert G.; Hubbs, Jessica L.; Evans, Elizabeth S.; Zhou, Shu; Yu, Xiaoli; Blazing, Michael A.; Hollis, Donna; Tisch, A.; Wong, Terence Z.; Borges‐Neto, Salvador; Hardenbergh, Patricia H.; Marks, Lawrence B.

doi:10.1002/cncr.22965

Cited by 138 publications

(60 citation statements)

References 102 publications

(94 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…18,19 The role of radiation directed to the internal mammary nodes was questioned, particularly since its use was associated with radiation-associated cardiac death, which was probably attributable to outdated radiation techniques. [20][21][22][23][24][25][26][27][28][29] It remains undefined whether this risk is significantly lowered by advances in radiation techniques.…”

Section: Discussionmentioning

confidence: 99%

Internal Mammary and Medial Supraclavicular Irradiation in Breast Cancer

Collette²,

et al. 2015

View full text Add to dashboard Cite

BACKGROUND The effect of internal mammary and medial supraclavicular lymph-node irradiation (regional nodal irradiation) added to whole-breast or thoracic-wall irradiation after surgery on survival among women with early-stage breast cancer is unknown. METHODS We randomly assigned women who had a centrally or medially located primary tumor, irrespective of axillary involvement, or an externally located tumor with axillary involvement to undergo either whole-breast or thoracic-wall irradiation in addition to regional nodal irradiation (nodal-irradiation group) or whole-breast or thoracicwall irradiation alone (control group). The primary end point was overall survival. Secondary end points were the rates of disease-free survival, survival free from distant disease, and death from breast cancer. RESULTS Between 1996 and 2004, a total of 4004 patients underwent randomization. The majority of patients (76.1%) underwent breast-conserving surgery. After mastectomy, 73.4% of the patients in both groups underwent chest-wall irradiation. Nearly all patients with node-positive disease (99.0%) and 66.3% of patients with node-negative disease received adjuvant systemic treatment. At a median followup of 10.9 years, 811 patients had died. At 10 years, overall survival was 82.3% in the nodal-irradiation group and 80.7% in the control group (hazard ratio for death with nodal irradiation, 0.87; 95% confidence interval [CI], 0.76 to 1.00; P=0.06). The rate of disease-free survival was 72.1% in the nodal-irradiation group and 69.1% in the control group (hazard ratio for disease progression or death, 0.89; 95% CI, 0.80 to 1.00; P=0.04), the rate of distant disease-free survival was 78.0% versus 75.0% (hazard ratio, 0.86; 95% CI, 0.76 to 0.98; P=0.02), and breast-cancer mortality was 12.5% versus 14.4% (hazard ratio, 0.82; 95% CI, 0.70 to 0.97; P=0.02). Acute side effects of regional nodal irradiation were modest. CONCLUSIONS In patients with early-stage breast cancer, irradiation of the regional nodes had a marginal effect on overall survival. Disease-free survival and distant disease-free survival were improved, and breast-cancer mortality was reduced. (Funded by Fonds Cancer; ClinicalTrials.gov number, NCT00002851.).

show abstract

Section: Discussionmentioning

confidence: 99%

Internal Mammary and Medial Supraclavicular Irradiation in Breast Cancer

Collette²,

et al. 2015

View full text Add to dashboard Cite

show abstract

“…Typowo po radioterapii występuje długi okres latencji, w którym CAD jest bezobjawowa, a objawy mogą wystąpić ok. 10 lat po początkowym leczeniu nowotworu [143]. Obraz kliniczny CAD jest częściej nietypowy, a częstość występowania niemego niedokrwienia może być większa niż u pacjentów z CAD wywołaną klasycznymi czynnikami ryzyka [144,145], być może z powodu jednoczesnej neurotoksyczności radioterapii lub też zmiany postrzegania dławicy przez pacjentów w następstwie chemioterapii. Opisywano nagłe zgony sercowe u chorych po radioterapii wiązane z rozlaną hiperplazją błony wewnętrznej wszystkich tętnic wieńcowych lub istotnym zwężeniem pnia lewej tętnicy wieńcowej [128,130,136].…”

Section: Postępowanie Diagnostyczne I Terapeutyczneunclassified

2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines

Zamorano¹,

Lancellotti²,

Muñoz³

et al. 2016

Kardiol Pol

View full text Add to dashboard Cite

“…10 On the other hand, Hodgkin's lymphoma and breast cancer have long-term observation periods; there are also long-term reports about radiotherapyassociated cardiac toxicity in Hodgkin's lymphoma and breast cancer, and it has been recommended that the dose to the heart should be kept as low as possible. 20,21 The differences between oesophageal cancer and other reported tumours include differences related to the short follow-up period coming from the short survival of such patients, cardiotoxic chemotherapy, such as adriamycin, high RT doses and the radiation field. It is also thought that late adverse events were not evident owing to the short follow-up period.…”

Section: Fukada Et Almentioning

confidence: 99%

Predictive factors for pericardial effusion identified by heart dose–volume histogram analysis in oesophageal cancer patients treated with chemoradiotherapy

Hayashi¹,

Fujiwara²,

Nomura³

et al. 2015

BJR

View full text Add to dashboard Cite

with oesophageal cancer treated with chemoradiotherapy (CRT) using the following criteria were evaluated: radiation dose .50 Gy; heart included in the radiation field; dose-volume histogram (DVH) data available for analysis; no previous thoracic surgery; and no PCE before treatment. The diagnosis of PCE was independently determined by two radiologists. Clinical factors, the percentage of heart volume receiving .5-60 Gy in increments of 5 Gy (V5-60, respectively), maximum heart dose and mean heart dose were analysed. Results: A total of 143 patients with oesophageal cancer were reviewed retrospectively. The median follow-up by CT was 15 months (range, 2.1-72.6 months) after RT. PCE developed in 55 patients (38.5%) after RT, and the median time to develop PCE was 3.5 months (range, 0.2-9.9 months). On univariate analysis, DVH parameters except for V60 were significantly associated with the development of PCE (p , 0.001). No clinical factor was significantly related to the development of PCE.Recursive partitioning analysis including all DVH parameters as variables showed a V10 cut-off value of 72.8% to be the most influential factor. Conclusion:The present results showed that DVH parameters are strong independent predictive factors for the development of PCE in patients with oesophageal cancer treated with CRT. Advances in knowledge: A heart dosage was associated with the development of PCE with radiation and without prophylactic nodal irradiation.

show abstract

Prospective assessment of radiotherapy‐associated cardiac toxicity in breast cancer patients: Analysis of data 3 to 6 years after treatment

Cited by 138 publications

References 102 publications

Internal Mammary and Medial Supraclavicular Irradiation in Breast Cancer

Internal Mammary and Medial Supraclavicular Irradiation in Breast Cancer

2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines

Predictive factors for pericardial effusion identified by heart dose–volume histogram analysis in oesophageal cancer patients treated with chemoradiotherapy

Contact Info

Product

Resources

About