Please use this identifier to cite or link to this item:
http://doi.org/10.25358/openscience-7647
Authors: | Merzenich, Hiltrud Baaken, Dan Schmidt, Marcus Bekes, Inga Schwentner, Lukas Janni, Wolfgang Woeckel, Achim Bartkowiak, Detlef Wiegel, Thomas Blettner, Maria Wollschläger, Daniel Schmidberger, Heinz |
Title: | Cardiac late effects after modern 3D-conformal radiotherapy in breast cancer patients : a retrospective cohort study in Germany (ESCaRa) |
Online publication date: | 30-Aug-2022 |
Year of first publication: | 2022 |
Language: | english |
Abstract: | 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 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. |
DDC: | 610 Medizin 610 Medical sciences |
Institution: | Johannes Gutenberg-Universität Mainz |
Department: | FB 04 Medizin |
Place: | Mainz |
ROR: | https://ror.org/023b0x485 |
DOI: | http://doi.org/10.25358/openscience-7647 |
Version: | Published version |
Publication type: | Zeitschriftenaufsatz |
License: | CC BY |
Information on rights of use: | https://creativecommons.org/licenses/by/4.0/ |
Journal: | Breast cancer research and treatment 191 |
Pages or article number: | 147 157 |
Publisher: | Springer Science + Business Media B.V. |
Publisher place: | Dordrecht u.a. |
Issue date: | 2022 |
ISSN: | 1573-7217 |
Publisher DOI: | 10.1007/s10549-021-06412-3 |
Appears in collections: | JGU-Publikationen |
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