Were We Able to Reduce Cardiac Doses in Breast Cancer Radiotherapy Over Time?

Altınok, Pelin; Korkmaz, Latif; Altinok, A.; Beşe, Nuran

doi:10.4274/ejbh.galenos.2021.6148

Cited by 2 publications

(1 citation statement)

References 11 publications

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“…The risk of cardiac toxicity due to adjuvant RT could begin within a few years after treatment and may continue for more than 15 years. Recent studies showed that a significant decrease in cardiac and left coronary artery doses is likely to reduce long-term side effects [ 28 ]. Previous epidemiological studies on post-radiotherapy cardiotoxicity showed that the MHD doses are typically described as those received by the entire heart, and it may thus be a dose criterion for RT-induced cardiotoxicity [ 29 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

Accelerated coronary calcium burden in breast cancer patients after radiotherapy: a comparison with age and race matched healthy women

2021

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Background Radiotherapy (RT) might lead to atherosclerotic plaque buildup and coronary artery stenosis of breast cancer (BC) survivors, and coronary artery calcium (CAC) might be a sign of preclinical atherosclerosis. This study explores possible determinants affecting the acceleration of CAC burden in BC patients after adjuvant RT. Methods Female BC patients receiving adjuvant RT from 2002 to 2010 were included. All patients received noncontrast computed tomography (NCCT) of thorax before and after adjuvant RT. Their CAC burden was compared with healthy controls from the Multi-Ethnic Study of Atherosclerosis (MESA) cohort. The progression of the CAC burden was manifested by the increment of CAC percentiles (%CACinc). Results Ninety-four patients, including both left- and right-side BC, were enrolled in this study. From undergoing the first to second NCCT, the %CACinc in BC patients significantly increased rather than non-BC women. In addition, the %CACinc was significantly higher in left-side than right-side BC patients (p < 0.05), and significant differences in most heart outcomes were found between the two groups. Besides, the lower the mean right coronary artery (RCA) dose, the lower the risks of CAC percentiles increase ≥ 50% after adjusting the disease's laterality. Conclusions A significantly higher accelerated CAC burden in BC patients than non-BC women represents that BC could affect accelerated CAC. A higher risk of accelerated CAC burden was found in left-side than right-side BC patients after adjuvant RT. A decrease of the mean RCA dose could reduce more than 50% of the risk of accelerated CAC burden in BC patients.

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Section: Discussionmentioning

confidence: 99%

Accelerated coronary calcium burden in breast cancer patients after radiotherapy: a comparison with age and race matched healthy women

2021

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Left breast radiotherapy – the impact of heart and left anterior descending artery doses to cardiovascular diseases developed eight years after treatment

Petrović

Djuran

et al. 2022

Srp Arh Celok Lek

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Introduction/Objective. Left breast cancer patients undergoing radiotherapy are at higher risk of cardiovascular diseases (CVD), as a partial volume of the heart is anatomically close to target volume. This may cause cardiovascular diseases in the years following cancer treatment. The aim of this work was to develop a scoring system which identifies patients with increased risk of development of cardiovascular diseases, as consequence of left breast irradiation. Methods. The patients followed up in this study were treated during 2009. Eight years later, they were invited to participate in a study where they underwent a cardiology evaluation. Their current condition was statistically correlated to the doses received by their heart and left anterior descendant (LAD) artery. Results. Out of 114 patients, thirty-one women were evaluable for cardiology assessment. Out of these 31 subjects, six women were with a history of CVD before cancer treatment. Four women never developed any kind of heart associated disease, while in the other 27, newly onset CVD were diagnosed ranging from hypertension to myocardial infarction, strongly positively correlated to doses to heart and LAD (p = 0.003). Severity of developed cardiovascular toxicity was formulated through the correlation of mean heart and mean LAD doses with cardiovascular diseases developed in form of the scoring system. Conclusion. The doses to critical organs depend on patient anatomy and technique of irradiation. The cardiovascular complications are proven as consequence of radiotherapy. Scoring system based on doses received by heart and LAD is reliable tool in predicting CVD.

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Were We Able to Reduce Cardiac Doses in Breast Cancer Radiotherapy Over Time?

Cited by 2 publications

References 11 publications

Accelerated coronary calcium burden in breast cancer patients after radiotherapy: a comparison with age and race matched healthy women

Accelerated coronary calcium burden in breast cancer patients after radiotherapy: a comparison with age and race matched healthy women

Left breast radiotherapy – the impact of heart and left anterior descending artery doses to cardiovascular diseases developed eight years after treatment

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