Adjuvant Whole Breast Radiotherapy Improve Survival in Women with Heart Failure with Reduced Ejection Fraction Receiving Breast-Conserving Surgery

被引:2
作者
Zhang, Jiaqiang [1 ]
Sum, Shao-Yin [2 ]
Hsu, Jeng-Guan [3 ]
Chiang, Ming-Feng [4 ]
Lee, Tian-Shyug [3 ]
Wu, Szu-Yuan [3 ,5 ,6 ,7 ,8 ,9 ,10 ]
机构
[1] Zhengzhou Univ, Henan Prov Peoples Hosp, Peoples Hosp, Dept Anesthesiol & Perioperat Med, Zhengzhou 450052, Peoples R China
[2] Lotung Poh Ai Hosp, Lo Hsu Med Fdn, Dept Gen Surg, Yilan 265, Taiwan
[3] Fu Jen Catholic Univ, Grad Inst Business Adm, New Taipei 242062, Taiwan
[4] Lotung Poh Ai Hosp, Lo Hsu Med Fdn, Dept Internal Med, Div Gastroenterol & Hepatol, Yilan 265, Taiwan
[5] Asia Univ, Coll Med & Hlth Sci, Dept Food Nutr & Hlth Biotechnol, Taichung 413, Taiwan
[6] Lotung Poh Ai Hosp, Lo Hsu Med Fdn, Canc Ctr, Big Data, Yilan 265, Taiwan
[7] Lotung Poh Ai Hosp, Lo Hsu Med Fdn, Div Radiat Oncol, Yilan 265, Taiwan
[8] Asia Univ, Coll Med & Hlth Sci, Dept Healthcare Adm, Taichung 413, Taiwan
[9] Taipei Med Univ, Taipei Municipal Wan Fang Hosp, Ctr Reg Anesthesia, Taipei 110, Taiwan
[10] Taipei Med Univ, Taipei Municipal Wan Fang Hosp, Ctr Pain Med, Taipei 110, Taiwan
关键词
breast cancer; radiotherapy-related cardiotoxicity; breast-conserving surgery; radiotherapy; survival; TOTAL INTRAVENOUS ANESTHESIA; INSURANCE RESEARCH DATABASE; CARDIOVASCULAR-DISEASE; CANCER; RISK; DOXORUBICIN; VALIDATION; MORTALITY; THERAPY; MASTECTOMY;
D O I
10.3390/jpm11121358
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Background: to date, no data on the effect of adjuvant whole breast radiotherapy (WBRT) on oncologic outcomes, such as all-cause death, locoregional recurrence (LRR), and distant metastasis (DM), are available in women with left-side breast invasive ductal carcinoma (IDC) and heart failure with reduced ejection fraction (HFrEF). Patients and Methods: we included 294 women with left-breast IDC at clinical stages IA-IIIC and HFrEF receiving breast-conserving surgery (BCS) followed by adjuvant WBRT or non-adjuvant WBRT. We categorized them into two groups based on their adjuvant WBRT status and compared their overall survival (OS), LRR, and DM outcomes. We calculated the propensity score and applied inverse probability of treatment weighting (IPTW) to create a pseudo-study cohort. Furthermore, we performed a multivariate analysis of the propensity score-weighted population to obtain hazard ratios (HRs). Results: in the IPTW-adjusted model, adjuvant WBRT (adjusted HR [aHR]: 0.60; 95% confidence interval [CI]: 0.44-0.94) was a significant independent prognostic factor for all-cause death (p = 0.0424), and the aHR (95% CI) of LRR and DM for adjuvant WBRT was 0.33 (0.24-0.71; p = 0.0017) and 0.37 (0.22-0.63; p = 0.0004), respectively, compared with the non-adjuvant WBRT group. Conclusion: Adjuvant WBRT was associated with a decrease in all-cause death, LRR, and DM in women with left IDC and HFrEF compared with non-adjuvant WBRT.
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页数:16
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