Key result
Higher heart and LAD radiotherapy doses strongly correlate with incident CVD 8 years after breast cancer.
Why the study?
Left breast cancer radiotherapy increases cardiovascular disease risk due to cardiac exposure, prompting the development of a scoring system to identify patients at increased risk based on heart and LAD radiation doses.
Do the radiation doses to the heart and left anterior descending artery during left breast radiotherapy correlate with the development of cardiovascular diseases 8 years later?
Cohort (n=31)
Do the radiation doses to the heart and left anterior descending artery during left breast radiotherapy correlate with the development of cardiovascular diseases 8 years later?
p-value: p=0.003
Radiation doses to the heart and left anterior descending artery during left breast cancer radiotherapy are strongly correlated with the development of cardiovascular diseases 8 years later, supporting the use of a predictive scoring system.
May warrant cardiac dose minimization in left breast radiotherapy; hypothesis-generating for predictive models and requires prospective validation.
Introduction/Objective Left breast cancer patients undergoing radiotherapy are at higher risk of cardiovascular diseases (CVD), as a partial volume of the heart is anatomically close to target volume. This may cause CVD in the years following cancer treatment. The aim of this work was to develop a scoring system which identifies patients with increased risk of development of CVD, as a consequence of the left breast irradiation. Methods The patients followed up in this study were treated during 2009. Eight years later, they were invited to participate in a study where they underwent a cardiology evaluation. Their current condition was statistically correlated to the doses received by their heart and left anterior descendant artery (LAD). Results Out of 114 patients, 31 women were evaluable for cardiology assessment. Out of these 31 subjects, six women were with a history of CVD before cancer treatment. Four women never developed any kind of heart associated disease, while in the other 27, newly onset CVD were diagnosed ranging from hypertension to myocardial infarction, strongly positively correlated to doses to heart and LAD (p = 0.003). Severity of developed cardiovascular toxicity was formulated through the correlation of mean heart and mean LAD doses with CVD developed in the form of a scoring system. Conclusion The doses to critical organs depend on patient anatomy and technique of irradiation. The cardiovascular complications are proven as consequence of radiotherapy. Scoring system based on doses received by heart and LAD is a reliable tool in predicting CVD.
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Petrović et al. (2022) conducted a cohort in Left breast cancer (n=31). Radiotherapy doses to heart and left anterior descending artery was evaluated on Newly onset cardiovascular diseases (p=0.003). Radiotherapy doses to the heart and left anterior descending artery were strongly positively correlated with newly onset cardiovascular diseases 8 years after left breast cancer treatment (p=0.003).
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