Potential impact of cardiac dose–volume on acute cardiac toxicity following concurrent trastuzumab and radiotherapy
| Autor: | X.M. Guo, G. Cai, Y.M. Kirova, Z.M. Shao, L. Cao, Z.Z. Yang, W.G. Hu, J.L. Ma, J.Y. Chen, X.L. Yu |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Oncology medicine.medical_specialty Receptor ErbB-2 medicine.medical_treatment Urology Antineoplastic Agents Breast Neoplasms Antibodies Monoclonal Humanized Ventricular Function Left Breast cancer Risk Factors Trastuzumab Cardiac toxicity Internal medicine medicine Humans Radiology Nuclear Medicine and imaging Aged Retrospective Studies Cardiotoxicity Ejection fraction business.industry Medical record Radiotherapy Dosage Stroke Volume Middle Aged medicine.disease Radiation therapy medicine.anatomical_structure Chemotherapy Adjuvant Ventricle Female Radiotherapy Adjuvant Radiotherapy Intensity-Modulated Tomography X-Ray Computed business Follow-Up Studies medicine.drug |
| Zdroj: | Cancer/Radiothérapie. 18:119-124 |
| ISSN: | 1278-3218 |
| Popis: | To analyse the risk factors associated with acute cardiotoxicity in HER2-positive breast cancer patients receiving concurrent trastuzumab and radiotherapy.Medical records of 45 breast cancer patients treated between 02/2009 and 02/2011 by concurrent trastuzumab and radiotherapy were collected. Radiation was delivered to the conserved breast or chest wall with or without regional nodes. Dose prescription was 50Gy in 25 fractions over five weeks with a tumor bed boost of 10Gy in 5 fractions in breast conservation. Acute cardiotoxicity (grade≥1) was defined using NCI-CTC v2.0. Doses to the heart and left ventricle were quantified.Median follow-up of left ventricular ejection fraction and clinical assessment from the completion of radiotherapy was 10 months (range: 3-27 months) and 25 months (range: 13-40 months), respectively. Ten (22.2%) and one (2.2%) of the 45 patients developed grade 1 and grade 2 cardiotoxicity, respectively. For 24 left-sided patients, the mean heart dose was significantly higher in those with cardiac events compared to those without (10.14 and 6.27Gy, respectively; P0.05). A continuous increase of D17-D57 and V10-V15 of the heart and increase of D40-D80 and V5-V7 of the left ventricle were statistically significant in left-sided patients who developed cardiotoxicity compared with those who did not (P0.05). No significant relationship of dosimetric parameters of cardiac structures and cardiac events was found in right-sided patients.Left-sided irradiation with increased low dose-volume and mean heart dose were associated with increased but reversible low-grade early cardiac toxicity after use of concurrent trastuzumab. |
| Databáze: | OpenAIRE |
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