Cardiac late effects after modern 3D-conformal radiotherapy in breast cancer patients: a retrospective cohort study in Germany (ESCaRa)
Please always quote using this URN: urn:nbn:de:bvb:20-opus-308606
- Purpose Radiotherapy (RT) was identified as a risk factor for long-term cardiac effects in breast cancer patients treated until the 1990s. However, modern techniques reduce radiation exposure of the heart, but some exposure remains unavoidable. In a retrospective cohort study, we investigated cardiac mortality and morbidity of breast cancer survivors treated with recent RT in Germany. Methods A total of 11,982 breast cancer patients treated between 1998 and 2008 were included. A mortality follow-up was conducted until 06/2018. In order toPurpose Radiotherapy (RT) was identified as a risk factor for long-term cardiac effects in breast cancer patients treated until the 1990s. However, modern techniques reduce radiation exposure of the heart, but some exposure remains unavoidable. In a retrospective cohort study, we investigated cardiac mortality and morbidity of breast cancer survivors treated with recent RT in Germany. Methods A total of 11,982 breast cancer patients treated between 1998 and 2008 were included. A mortality follow-up was conducted until 06/2018. In order to assess cardiac morbidity occurring after breast cancer treatment, a questionnaire was sent out in 2014 and 2019. The effect of breast cancer laterality on cardiac mortality and morbidity was investigated as a proxy for radiation exposure. We used Cox Proportional Hazards regression analysis, taking potential confounders into account. Results After a median follow-up time of 11.1 years, there was no significant association of tumor laterality with cardiac mortality in irradiated patients (hazard ratio (HR) for left-sided versus right-sided tumor 1.09; 95% confidence interval (CI) 0.85–1.41). Furthermore, tumor laterality was not identified as a significant risk factor for cardiac morbidity (HR = 1.05; 95%CI 0.88–1.25). Conclusions Even though RT for left-sided breast cancer on average incurs higher radiation dose to the heart than RT for right-sided tumors, we found no evidence that laterality is a strong risk factor for cardiac disease after contemporary RT. However, larger sample sizes, longer follow-up, detailed information on individual risk factors and heart dose are needed to assess clinically manifest late effects of current cancer therapy.…
Author: | Hiltrud Merzenich, Dan Baaken, Marcus Schmidt, Inga Bekes, Lukas Schwentner, Wolfgang Janni, Achim Woeckel, Detlef Bartkowiak, Thomas Wiegel, Maria Blettner, Daniel Wollschläger, Heinz Schmidberger |
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URN: | urn:nbn:de:bvb:20-opus-308606 |
Document Type: | Journal article |
Faculties: | Medizinische Fakultät / Frauenklinik und Poliklinik |
Language: | English |
Parent Title (English): | Breast Cancer Research and Treatment |
ISSN: | 0167-6806 |
ISSN: | 1573-7217 |
Year of Completion: | 2022 |
Volume: | 191 |
Issue: | 1 |
Pagenumber: | 147-157 |
Source: | Breast Cancer Research and Treatment (2022) 191:1, 147–157. https://doi.org/10.1007/s10549-021-06412-3 |
DOI: | https://doi.org/10.1007/s10549-021-06412-3 |
Dewey Decimal Classification: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
Tag: | 3D-conformal radiotherapy; breast cancer; cardiac morbidity; cardiac mortality; cohort study; survival |
Release Date: | 2024/06/18 |
Date of first Publication: | 2022/01/01 |
Licence (German): | CC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International |