Exposure of the heart and cardiac valves in women irradiated for breast cancer 1970-2009.

Autor:	Duane FK; St. Luke's Radiation Oncology Network, St. Luke's Hospital, Dublin, Ireland.; School of Medicine, Trinity College Dublin, Ireland.; Trinity St James's Cancer Institute, St James's Hospital, Dublin, Ireland., Boekel NB; Netherlands Cancer Institute, Epidemiology, Amsterdam, The Netherlands., Jacobse JN; Netherlands Cancer Institute, Epidemiology, Amsterdam, The Netherlands., Wang Z; Nuffield Department of Population Health, University of Oxford, UK., Aleman BMP; Netherlands Cancer Institute, Radiation Oncology, Amsterdam, The Netherlands., Darby SC; Nuffield Department of Population Health, University of Oxford, UK., Schaapveld M; Netherlands Cancer Institute, Epidemiology, Amsterdam, The Netherlands., van Leeuwen FE; Netherlands Cancer Institute, Epidemiology, Amsterdam, The Netherlands., Baaijens MHA; Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Centre, Rotterdam, The Netherlands., Warren S; Northern Centre for Cancer Care, Freeman Hospital, Newcastle Upon Tyne, UK., Taylor CW; Nuffield Department of Population Health, University of Oxford, UK.
Jazyk:	angličtina
Zdroj:	Clinical and translational radiation oncology [Clin Transl Radiat Oncol] 2022 Jul 16; Vol. 36, pp. 132-139. Date of Electronic Publication: 2022 Jul 16 (Print Publication: 2022).
DOI:	10.1016/j.ctro.2022.07.004
Abstrakt:	Purpose: To describe cardiac exposure from breast cancer radiotherapy regimens used during 1970-2009 for the development of dose-response relationships and to consider the associated radiation-risks using existing dose-response relationships. Material and Methods: Radiotherapy charts for 771 women in the Netherlands selected for case control studies of heart disease after breast cancer radiotherapy were used to reconstruct 44 regimens on a typical CT-dataset. Doses were estimated for the whole heart (WH), left ventricle (LV) and cardiac valves. Results: For breast/chest wall radiotherapy average WH doses decreased during 1970-2009. For internal mammary chain (IMC) radiotherapy WH doses were highest during the 1980s and 1990s when direct anterior fields were used and reduced in the 2000s when oblique fields were introduced. Average doses varied substantially for IMC regimens (WH 2-33 Gy, LV < 1-23 Gy). For cardiac valves, at least one valve received >30 Gy from most regimens. Conclusions: Radiation-risks of IHD from breast/chest wall regimens likely reduced during 1970-2009. Direct anterior IMC regimens likely increased the risks of IHD and VHD over this time period but the use of oblique IMC fields from 2003 may have lowered these risks. These data provide a unique opportunity to develop dose-response relationships. Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Dr. Warren reports non-financial support from Raystation UK Users Meeting May 2019, outside the submitted work. (© 2022 The Author(s).)
Databáze:	MEDLINE
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