From the US-SEER cancer registries, it appeared that radiation therapy (RT), administered between 1973 and 1982, resulted in an increased mortality rate up to 10-20 years after treatment for left-sided breast cancer (BC) patients [1].Furthermore, Darby et al. reported that major cardiac events (MCE) incidence rates increased linearly with mean heart dose (MHD) by 7.4% relative per Gray [2].Similar results were found in two Dutch and one Danish study [3][4][5].Thereafter, MHD is used as a normative planning parameter in BC-RT in daily practice as well as in studies [6][7][8].Recently, though, the presence of a dose-effect relationship was not confirmed [9,10].Therefore, we decided to evaluate whether a linear association between MHD and MCE-incidence rates still applies and noted:
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Struikmans et al. (2024) studied this question.
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