Modern radiotherapy for early-stage breast cancer did not cause significant early changes in cardiac function or biomarkers within 2 weeks post-treatment in 124 women.
Does modern radiotherapy cause early cardiotoxic effects on ventricular function or cardiac biomarkers in women with early-stage breast cancer?
Modern radiotherapy protocols for early-stage breast cancer do not appear to cause significant early cardiotoxicity as measured by echocardiography and cardiac biomarkers within 2 weeks of treatment.
Absolute Event Rate: 0% vs 0%
Abstract Background Breast cancer is a highly curable disease and radiotherapy (RT) is an important part of treatment with a significant impact on survival. RT related long-term side effects to the heart can be an important concern, including increased risk of coronary artery disease, myocardial dysfunction, valvular disease and pericardial disease. However, the early effect of RT on cardiac structure and function is not well understood. Purpose To evaluate early cardiotoxic effect of RT in early-stage breast cancer women treated solely with surgery and modern RT protocol. Methods The prospective study included 124 women (57±8 years) with ductal carcinoma in-situ (DCIS) of the breast who had undergone surgical tumorectomy and RT. Exclusion criteria were known cardiac disease, prior systemic chemotherapy or prior RT. Women were treated with 3-dimensional conformal RT or intensity-modulated RT. Left-sided DCIS patients (62 (50%)) were also scheduled for deep inspiration breath hold protocol, if feasible. Echocardiographic examination, including left (LV) and right (RV) ventricular function, were performed prior to RT and within 2 weeks after RT. At the same time, cardiac biomarkers (troponin, NT-proBNP) were analysed. Results The mean RT dose was 40.5±1.5 Gy, while the mean heart dose was 0.92±0.49 Gy and was significantly higher in women with left-sided RT than in right-sided RT (1.10±0.59 Gy vs 0.72±0.28 Gy; p0.001). There was a weak correlation between mean heart dose and LV global longitudinal strain (GLS) (r=0.313; p=0.001) as well as with non-invasive estimation of LV filling pressure (E/e`) (r=-0.315; p=0.001). However, there were no significant changes in parameters of systolic and diastolic function before and after RT, both in women with right-sided RT or left-sided RT (Figure). There were also no dynamic changes in cardiac markers such as NT-proBNP and troponin (p0,05), respectively. Conclusions Our results suggest that isolated modern RT for breast cancer does not cause significant early adverse effects on left or right cardiac function. Modern RT seems to be safe in terms of early cardiotoxic effects, but further follow-up is needed to assess potential long-term side effects.
Cvijić et al. (Sat,) reported a other. Modern radiotherapy for early-stage breast cancer did not cause significant early changes in cardiac function or biomarkers within 2 weeks post-treatment in 124 women.