Elisa K Chan1, Ryan Woods2, Sean Virani3, Caroline Speers4, Elaine S Wai5, Alan Nichol6, Mary L McBride2, Scott Tyldesley7. 1. Department of Oncology, Saint John Regional Hospital, Canada. 2. BC Cancer Agency, Cancer Control Research Department, Vancouver, Canada. 3. Division of Cardiology, University of British Columbia, Vancouver, Canada. 4. BC Cancer Agency, Breast Cancer Outcomes Unit, Vancouver, Canada. 5. BC Cancer Agency, Radiation Therapy Program, Victoria, Canada. 6. BC Cancer Agency, Radiation Therapy Program, Vancouver, Canada. 7. BC Cancer Agency, Radiation Therapy Program, Vancouver, Canada. Electronic address: styldesl@bccancer.bc.ca.
Abstract
BACKGROUND AND PURPOSE: Ongoing concern remains regarding cardiac injury with hypofractionated whole breast/chest-wall radiotherapy (HF-WBI) compared to conventional radiotherapy (CF-WBI) in left-sided breast cancer patients. The purpose was to determine if cardiac mortality increases with HF-WBI relative to CF-WBI. MATERIALS AND METHODS: Between 1990 and 1998, 5334 women with early-stage breast cancer received post-operative radiotherapy to the breast/chest wall alone. A population-based database recorded baseline patient, tumor and treatment factors. Baseline cardiovascular risk factors were identified from hospital administrative records. A propensity-score model balanced risk factors between radiotherapy groups. Cause of death was coded as breast cancer, cardiac or other cause. Cumulative mortality from each cause after radiotherapy was estimated using a competing risk approach. RESULTS: For left-sided cases, median follow-up was 14.2 years. 485 women received CF-WBI, 2221 women received HF-WBI. There was no difference in 15-year mortality from cardiac causes: 4.8% with HF-WBI and 4.2% with CF-WBI (p=0.74), even after propensity-score adjustment (p=0.45). There was no difference in breast cancer mortality or other cause mortality. For right-sided cases, there was no difference in mortality for the three causes of death. CONCLUSIONS: At 15-years follow-up, cardiac mortality is not statistically different among left-sided breast cancer patients treated with HF-WBI or CF-WBI.
BACKGROUND AND PURPOSE: Ongoing concern remains regarding cardiac injury with hypofractionated whole breast/chest-wall radiotherapy (HF-WBI) compared to conventional radiotherapy (CF-WBI) in left-sided breast cancerpatients. The purpose was to determine if cardiac mortality increases with HF-WBI relative to CF-WBI. MATERIALS AND METHODS: Between 1990 and 1998, 5334 women with early-stage breast cancer received post-operative radiotherapy to the breast/chest wall alone. A population-based database recorded baseline patient, tumor and treatment factors. Baseline cardiovascular risk factors were identified from hospital administrative records. A propensity-score model balanced risk factors between radiotherapy groups. Cause of death was coded as breast cancer, cardiac or other cause. Cumulative mortality from each cause after radiotherapy was estimated using a competing risk approach. RESULTS: For left-sided cases, median follow-up was 14.2 years. 485 women received CF-WBI, 2221 women received HF-WBI. There was no difference in 15-year mortality from cardiac causes: 4.8% with HF-WBI and 4.2% with CF-WBI (p=0.74), even after propensity-score adjustment (p=0.45). There was no difference in breast cancer mortality or other cause mortality. For right-sided cases, there was no difference in mortality for the three causes of death. CONCLUSIONS: At 15-years follow-up, cardiac mortality is not statistically different among left-sided breast cancerpatients treated with HF-WBI or CF-WBI.
Authors: Katherine E Henson; Paul McGale; Sarah C Darby; Max Parkin; Yaochen Wang; Carolyn W Taylor Journal: Int J Cancer Date: 2020-03-04 Impact factor: 7.396
Authors: D Singh; G Saini; R Koul; V Gupta; D Abrol; S De; P Kulshrestha; S N Hukku; S J Lakshmi; Purvish M Parikh; S Aggarwal Journal: South Asian J Cancer Date: 2018 Apr-Jun