Risk of coronary artery disease after adjuvant radiotherapy in 29,662 early breast cancer patients: A population-based Danish Breast Cancer Group study

被引：45

作者：

Milo, Marie Louise Holm ^{[1
]}

Thorsen, Lise Bech Jellesmark ^{[1
,2
]}

Johnsen, Soren Paaske ^{[3
]}

Nielsen, Kirsten Melgaard ^{[4
]}

Valentin, Jan Brink ^{[3
]}

Alsner, Jan ^{[1
]}

Offersen, Birgitte Vrou ^{[1
,2
,5
]}

机构：

[1] Aarhus Univ Hosp, Dept Expt Clin Oncol, Palle Juul Jensens Blvd 99, DK-8200 Aarhus N, Denmark

[2] Aarhus Univ Hosp, Dept Oncol, Aarhus, Denmark

[3] Aalborg Univ Hosp, Danish Ctr Clin Hlth Serv Res, Dept Clin Med, Aarhus, Denmark

[4] Aarhus Univ Hosp, Dept Cardiol, Aarhus, Denmark

[5] Danish Ctr Particle Therapy, Aarhus, Denmark

来源：

RADIOTHERAPY AND ONCOLOGY | 2021年 / 157卷

关键词：

Breast cancer; Radiotherapy; Coronary artery disease; Valvular heart disease; Long-term side effects; COOPERATIVE GROUP; POSTOPERATIVE RADIOTHERAPY; HEART-DISEASE; NODE IRRADIATION; DBCG-IMN; WOMEN; DENMARK;

D O I：

10.1016/j.radonc.2021.01.010

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose: Radiotherapy (RT) for early breast cancer (BC) reduces the risk of recurrence and improves over-all survival. However, thoracic RT may cause some incidental RT dose to the heart with subsequent risk of heart disease. During 2000-2010, CT-based RT planning was gradually introduced. The aim of this study was to investigate the risk of cardiac events in left-sided compared with right-sided BC patients treated during a non-CT-based (1999-2007) vs a CT-based period (2008-2016). Material and methods: Information on BC and cardiac events among Danish women was obtained from population-based medical registers. Patients diagnosed with BC during 1999-2016, were included. A car-diac event was defined as coronary artery disease or severe valvular heart disease. Results: Among 29,662 patients, 22,056 received RT. For those irradiated during the non-CT-based period, the 10-year cumulative risk of cardiac event was 1.7% (95% CI 1.4-2.0) at median follow-up of 11.1 years. The incidence rate ratio (IRR) for cardiac event in left-sided vs right-sided patients was 1.44 (1.07-1.94) anda trend towards worse outcome was seen within the first 10 years after RT and approached statistical significance with longer follow-up. Among patients irradiated during the CT-based period, the 10-year cumulative risk of cardiac event was 2.1% (1.8-2.4) at median 6.8 years follow-up. The IRR for cardiac event in left-sided vs right-sided patients was 0.90 (0.69-1.16) and no trend towards worse outcome within the first 10 years was observed. Conclusion: This study confirmed a higher risk of cardiac events in left-sided vs right-sided BC patients irradiated during a non-CT-based period. For patients irradiated during a CT-based period, no increased risk of cardiac events in left-sided vs right-sided patients was observed within the first 10 years after RT, whilst information on cardiac events beyond 10 years after RT was limited. (C) 2021 Elsevier B.V. All rights reserved.

引用

页码：106 / 113

页数：8

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