Please use this identifier to cite or link to this item:
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
Version: Published version
Publication type: Zeitschriftenaufsatz
License: CC BY
Information on rights of use:
Journal: Breast cancer research and treatment
Pages or article number: 147
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

Files in This Item:
  File Description SizeFormat
cardiac_late_effects_after_mo-20220829130447985.pdf961.79 kBAdobe PDFView/Open