Evaluation of radiation-induced cardiac toxicity in breast cancer patients treated with Trastuzumab-based chemotherapy

被引：26

作者：

Abouegylah, Mohamed ^{[1
,2
]}

Braunstein, Lior Z. ^{[3
]}

El-Din, Mohamed A. Alm ^{[4
]}

Niemierko, Andrzej ^{[1
]}

Salama, Laura ^{[5
]}

Elebrashi, Mostafa ^{[6
]}

Edgington, Samantha K. ^{[1
]}

Remillard, Kyla ^{[1
]}

Napolitano, Brian ^{[1
]}

Naoum, George E. ^{[1
]}

Sayegh, Hoda E. ^{[1
]}

Gillespie, Tessa ^{[1
]}

Farouk, Mohamed ^{[2
]}

Ismail, Abdelsalam A. ^{[2
]}

Taghian, Alphonse G. ^{[1
]}

机构：

[1] Harvard Med Sch, Massachusetts Gen Hosp, Dept Radiat Oncol, 100 Blossom St, Boston, MA 02114 USA

[2] Alexandria Univ, Fac Med, Dept Clin Oncol, Alexandria, Egypt

[3] Mem Sloan Kettering Canc Ctr, Dept Radiat Oncol, New York, NY 10065 USA

[4] Tanta Univ, Fac Med, Dept Clin Oncol, Tanta, Egypt

[5] FAU, Charles E Schmidit COM, Boca Raton, FL USA

[6] Ain Shams Univ, Fac Med, Dept Clin Oncol, Cairo, Egypt

来源：

BREAST CANCER RESEARCH AND TREATMENT | 2019年 / 174卷 / 01期

关键词：

Radiotherapy; Trastuzumab; Cardiotoxicity; Dose-volume histograms; INTERNAL MAMMARY CHAIN; ADJUVANT THERAPY; HEART-DISEASE; RADIOTHERAPY; CARDIOTOXICITY; TOLERABILITY; RISK;

D O I：

10.1007/s10549-018-5053-y

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

PurposePatients with Her2-positive breast cancer treated with trastuzumab have higher rates of cardiotoxicity (CT). Left-breast radiation might increase the risk for CT from cardiac exposure to radiation. The goal of our study is to evaluate the contribution of radiotherapy (RT) in the development of CT in breast cancer patients receiving trastuzumab.MethodsTwo hundred and two patients were treated with RT and trastuzumab from 2000 to 2014. The RT plans for left-side disease were recalled from archives. The heart, each chamber, and left anterior descending artery (LAD) were independently contoured. New dose-volume histograms (DVH) were generated. Their serial left-ventricular ejection fractions (LVEF) were studied. CT for left and right side were compared using Fisher's exact test. The DVH data were correlated with the predefined cardiac events using actuarial Cox regression analysis.ResultsCompared to the right sided, the left-side cases showed statistically significant development of arrhythmia (14.2%) versus (<1%) (p<0.001). Cardiac ischemia was found in 10 patients in left and one patient in right side (p=0.011). The equivalent uniform dose (EUD) to the left ventricle (LV), right ventricle (RV), and LAD was significantly associated with decrease in LVEF by >10% (p=0.037, p=0.023 and p=0.049, respectively).ConclusionsAmong patients treated for left-sided lesions, there were no significant differences in EF decline. However, there was a higher rate of ischemia and arrhythmia compared to those with right-sided disease. The EUD index of LV, RV, and LAD could be considered as a parameter to describe the risk of radiation-induced CT.

引用

页码：179 / 185

页数：7

共 18 条

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