Cardiac Function After Radiation Therapy for Breast Cancer.

Autor:	van den Bogaard VAB; Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands., van Luijk P; Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands., Hummel YM; Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands., van der Meer P; Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands., Schuit E; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands., Boerman LM; Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands., Maass SWMC; Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands., Nauta JF; Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands., Steggink LC; Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands., Gietema JA; Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands., de Bock GH; Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands., Berendsen AJ; Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands., Smit WGJM; Department of Radiation Oncology, Radiotherapy Institute Friesland, Leeuwarden, the Netherlands., Sijtsema NM; Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands., Kierkels RGJ; Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands., Langendijk JA; Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands., Crijns APG; Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands., Maduro JH; Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands. Electronic address: j.h.maduro@umcg.nl.
Jazyk:	angličtina
Zdroj:	International journal of radiation oncology, biology, physics [Int J Radiat Oncol Biol Phys] 2019 Jun 01; Vol. 104 (2), pp. 392-400. Date of Electronic Publication: 2019 Feb 11.
DOI:	10.1016/j.ijrobp.2019.02.003
Abstrakt:	Purpose: The main purpose of this study was to test the hypothesis that incidental cardiac irradiation is associated with changes in cardiac function in breast cancer (BC) survivors treated with radiation therapy (RT). Methods and Materials: We conducted a cross-sectional study consisting of 109 BC survivors treated with RT between 2005 and 2011. The endpoint was cardiac function, assessed by echocardiography. Systolic function was assessed with the left ventricular ejection fraction (LVEF) (n = 107) and the global longitudinal strain (GLS) of the left ventricle (LV) (n = 52). LV diastolic dysfunction (n = 109) was defined by e' at the lateral and septal region, which represents the relaxation velocity of the myocardium. The individual calculated RT dose parameters of the LV and coronary arteries were collected from 3-dimensional computed tomography-based planning data. Univariable and multivariable analysis using forward selection was performed to identify the best predictors of cardiac function. Robustness of selection was assessed using bootstrapping. The resulting multivariable linear regression model was presented for the endpoints of systolic and diastolic function. Results: The median time between BC diagnosis and echocardiography was 7 years. No relation between RT dose parameters and LVEF was found. In the multivariable analysis for the endpoint GLS of the LV, the maximum dose to the left main coronary artery was most often selected across bootstrap samples. For decreased diastolic function, the most often selected model across bootstrap samples included age at time of BC diagnosis and hypertension at baseline. Cardiac dose-volume histogram parameters were less frequently selected for this endpoint. Conclusions: This study shows an association between individual cardiac dose distributions and GLS of the LV after RT for BC. No relation between RT dose parameters and LVEF was found. Diastolic function was most associated with age and hypertension at time of BC diagnosis. Further research is needed to make definitive conclusions. (Copyright © 2019 Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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