Early detection and prediction of cardiotoxicity after radiation therapy for breast cancer: the BACCARAT prospective cohort study
| Autor: | D. Franck, Marianne Ducassou, Radia Tamarat, Jean Ferrières, Olivier Fondard, Atul Pathak, Fabien Milliat, S. Derreumaux, Matthieu Lapeyre, Benoit Fontenel, Olivier Lairez, Daniel Colombier, Sophie Jacob, Marc Benderitter, Igor Latorzeff, Dominique Laurier, Gaëlle Jimenez, Eric Bruguiere, David Broggio, Marie-Odile Bernier |
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| Přispěvatelé: | PRPHOM, SRBE, LEPID, Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Clinique Pasteur [Toulouse], CHU Rangueil, Laboratoire de Radiopathologie et Thérapies Expérimentales [IRSN, Fontenay-aux-Roses] (PRP-HOM - SRBE), Laboratoire de recherche en régénération des tissus sains irradiés [Fontenay-aux-Roses] (LR2I), Institut de Radioprotection et de Sûreté Nucléaire - IRSN [Fontenay-aux-Roses], PRP-HOM/SER/UEM, Radiation Protection and Nuclear Safety Institute, Institut de Radioprotection et de Sûreté Nucléaire (IRSN/PRP-HOM/SRBE) |
| Rok vydání: | 2016 |
| Předmět: |
Oncology
Time Factors [SDV]Life Sciences [q-bio] medicine.medical_treatment 030204 cardiovascular system & hematology Coronary artery disease Study Protocol Breast cancer 0302 clinical medicine Prospective Studies Myocardial infarction Prospective cohort study Cardiac imaging Heart dosimetry Heart Radiotherapy Dosage Middle Aged Coronary Vessels 3. Good health Phenotype Treatment Outcome Radiology Nuclear Medicine and imaging Echocardiography 030220 oncology & carcinogenesis Female medicine.medical_specialty Heart Diseases Breast Neoplasms 03 medical and health sciences Internal medicine medicine Humans Radiology Nuclear Medicine and imaging Functional and anatomical cardiac imaging Radiometry Aged Cardiotoxicity Radiotherapy business.industry Cardiac toxicity medicine.disease Surgery Radiation therapy Heart failure Quality of Life Neoplasm Recurrence Local business Biomarkers Follow-Up Studies |
| Zdroj: | Radiation Oncology (London, England) Radiation Oncology Radiation Oncology, 2016, 11 (1), pp.54. ⟨10.1186/s13014-016-0627-5⟩ |
| ISSN: | 1748-717X |
| DOI: | 10.1186/s13014-016-0627-5 |
| Popis: | International audience; Background Radiotherapy (RT) for breast cancer presents a benefit in terms of reducing local recurrence and deaths resulting from breast cancer but it can lead to secondary effects due to the presence of neighboring cardiac normal tissues within the irradiation field. Breast RT has been shown to be associated with long-term increased risk of heart failure, coronary artery disease, myocardial infarction and finally cardiovascular death more than 10 years after RT. However, there is still a lack of knowledge for early cardiotoxicity induced by breast RT that can appear long before the onset of clinically significant cardiac events. Based on a 2-year follow-up prospective cohort of patients treated with breast RT, the BACCARAT (BreAst Cancer and CArdiotoxicity Induced by RAdioTherapy) study aims to enhance knowledge on detection and prediction of early subclinical cardiac dysfunction and lesions induced by breast RT and on biological mechanisms potentially involved, based on functional and anatomical cardiac imaging combined with simultaneous assessment of multiple circulating biomarkers and accurate heart dosimetry. Methods/Design BACCARAT study consists in a monocentric prospective cohort study that will finally include 120 women treated with adjuvant 3D CRT for breast cancer, and followed for 2 years after RT. Women aged 50 to 70 years, treated for breast cancer and for whom adjuvant 3D CRT is indicated, without chemotherapy are eligible for the study. Baseline (before RT) and follow-up data include measurements of functional myocardial dysfunction including strain and strain rate based on 2D-speckle tracking echocardiography, anatomical coronary lesions including description of plaques in segments of coronary arteries based on Coronary computed tomography angiography, and a wide panel of circulating biomarkers. The absorbed dose is evaluated for the whole heart and its substructures, in particular the coronary arteries. Analysis on occurrence and evolution of subclinical cardiac lesions and biomarkers will be performed and completed with dose-response relationship. Multivariate model of normal tissue complication probability (NTCP) will also be proposed. Discussion Tools and results developed in the BACCARAT study should allow improving prediction and prevention of potential lesions to cardiac normal tissues surrounding tumors and ultimately enhance patients' care and quality of life. Trial registration ClinicalTrials.gov NCT02605512. © 2016 Jacob et al. |
| Databáze: | OpenAIRE |
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