Dexamethasone is Associated With a Lower Risk of the Progression of Thoracic Aortic Calcification in Breast Cancer Survivors

Figures

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  FIGURE 1. Flowchart of study. TAC indicates thoracic aortic calcification.

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  FIGURE 2. Relationship between the cumulative dose or cycle of dexamethasone and the increased TAC Agatston scores. Each symbol refers to one patient in Figures 2B,D. Boxplots showing median values (horizontal line inside the box), quartiles (box boundaries), and the largest and smallest observed values (lines drawn from the end of the box) in Figures 2A,C. (A) The cumulative dose of dexamethasone in different levels of increased TAC Agatston scores groups. *p < 0.05 versus the 0 or 0-100 group. (B) The cumulative dose of dexamethasone was negative correlation with the increased TAC Agatston scores (r = −0.303, p < 0.001). (C) The cycle of dexamethasone in different levles of increased TAC Agatston scores groups. *p < 0.05 versus the 0 group. (D) The cycle of dexamethasone was negative correlation with the increased TAC Agatston scores (r = −0.357, p < 0.001). TAC indicates. thoracic aortic calcification.

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  FIGURE 3. Inconsistency of radiotherapy exposure dose and locations of progression of TAC. (A) Locations of progression of TAC. The most common location of progression of TAC was the AOA, followed by DA and AA. Moreover, all new onset TAC were in the AOA. (B) CT of new onset AOA calcification in a female breast cancer survivor without TAC history. The radiation exposure dose of the thoracic aorta was displayed on CT, although the radiation exposure dose of AA was higher than that of AOA (217.4 versus 134.8 cGy), the new onset calcification occured at the AOA (marked with a red box) instead of AA. (C) Comparison radiation dose between different level of increased Agatston score groups. Histogram showing mean with standard deviation. AA indicates ascending aorta; AOA, arch of aorta; CT, computed tomography; DA, descending aorta; Gy, Gray; IM-RT, intensity modulated radiation therapy; No-RT, no radiation therapy; TAC, thoracic aortic calcification; 2D-RT, 2-dimensional radiation therapy.

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  FIGURE 4. Correlation between follow-up time and increased TAC Agatston scores. Each symbol refers to one patient. TAC indicates thoracic aortic calcification.

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  FIGURE 5. Relationship between the aorta volume and increased TAC Agatston scores in breast cancer patients with IM-RT. Each symbol refers to one patient in Figures 5B–E. (A) The aorta volume in different levels of increased TAC Agatston scores groups. Boxplots showing median values (horizontal line inside the box), quartiles (box boundaries), and the largest and smallest observed values (lines drawn from the end of the box). *p < 0.05 versus the 0 or 0-100 group. (B) The aorta volume was positively correlated with the increased TAC Agatston scores (r = 0.460, p < 0.001). (C–E), Spearman correlation analysis showed that no significant correlation between aorta radiation dosemean (r = −0.032, p = 0.789), dosemax (r = 0.030, p = 0.800), dosemin (r = −0.061, p = 0.608) and increased TAC Agatston scores. Dosemean indicates mean dose; dosemax, maximum dose; dosemin, minimum dose; Gy, Gray; IM-RT, intensity modulated radiation therapy; TAC, thoracic aortic calcification.