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Multimodal treatment strategies, including radiotherapy (RT), can help improve the overall survival rate of breast cancer (BC) patients
.
This also means that more and more BC survivors will face late treatment-related toxicity, including cardiotoxicity caused by radiation
.
The cumulative incidence of acute coronary events increased by 16.
At present, the clinically valuable dose limit for coronary arteries has not been fully determined
.
The clinically valuable dose limit for coronary arteries has not been fully established
A total of 94 patients participated in this study, including 51 left (54.
3%) and 43 right (45.
A total of 94 patients participated in this study, including 51 left (54.
Before 94 patients received adjuvant radiotherapy, 92 CAC percentiles were zero, and 68 patients were still zero after adjuvant radiotherapy
.
Before 94 patients received adjuvant radiotherapy, 92 CAC percentiles were zero, and 68 patients were still zero after adjuvant radiotherapy
%CACinc was significantly higher in patients with BC on the left than on the right (Figure 1)
.
%CACinc was significantly higher in patients with BC on the left than on the right (Figure 1)
Table 3 assesses possible factors that affect the clinical characteristics of %CACinc
.
%CACinc increased by 15.
13% (p=0.
02) in left BC patients than in right BC patients, possibly because part of the heart was close to or located in the left tangential irradiation field (Figure 2)
.
Table 3 assesses possible factors that affect the clinical characteristics of %CACinc
.
%CACinc increased by 15.
13% (p=0.
02) in left BC patients than in right BC patients, possibly because part of the heart was close to or located in the left tangential irradiation field (Figure 2)
.
Table 3 assesses possible factors that affect the clinical characteristics of %CACinc
.
%CACinc increased by 15.
13% (p=0.
02) in left BC patients than in right BC patients, possibly because part of the heart was close to or located in the left tangential irradiation field (Figure 2)
.
The dose variables on both sides of BC patients were analyzed, and the results showed that MHD, maximum cardiac dose, cardiac V25, average LAD dose , maximum LAD dose, average LCX dose, maximum LCX dose, and average RCA dose were significant between the two groups.
Sexual differences (Table 4)
.
between the two groups Sexual differences (Table 4) .
The results showed that there were significant differences in MHD, maximum cardiac dose, cardiac V25, and average LAD dose between the two groups (Table 4)
.
Table 5 calculates the correlation between the dose variables, indicating that there is a negative correlation between the MHD, the maximum cardiac dose, and the average LAD dose in patients with right BC
.
In addition, the average RCA dose of BC patients on the right side was negatively correlated with the dosimetry parameters of the entire BC population
.
.
In addition, the average RCA dose of BC patients on the right side was negatively correlated with the dosimetry parameters of the entire BC population
.
In addition, the average RCA dose of BC patients on the right side was negatively correlated with the dosimetry parameters of the entire BC population
.
We further divided all BC patients into two groups: %CACinc≥50% group and %CACinc<50% group, and calculated the risk of dose variables that caused the CAC percentage to increase by more than 50%
.
After adjusting the degree of disease , the maximum cardiac dose did not increase the risk of %CACinc (aOR of 1.
015) , but the average RCA dose significantly reduced the risk of increasing %CACinc, with aOR of 0.
47 (p=0.
039) (Table 6)
.
.
After adjusting the degree of disease , the maximum cardiac dose did not increase the risk of %CACinc (aOR of 1.
015) , but the average RCA dose significantly reduced the risk
of increasing %CACinc, with aOR of 0.
47 (p=0.
039) (Table 6) .
After adjusting the degree of disease, the maximum cardiac dose did not increase the risk of %CACinc (aOR of 1.
015) and increased the risk of %CACinc, with aOR of 0.
47 (p=0.
039) (Table 6)
.
In summary, this study reveals that the acceleration of the CAC burden of BC patients is significantly higher than that of non-BC women, indicating that BC may affect the progress of CAC burden
.
In addition, after adjuvant radiotherapy, the risk of accelerated CAC load in patients with left BC was significantly higher than that of patients with right BC
.
In addition, reducing the average RCA dose can reduce the risk of accelerated CAC load in BC patients by more than 50%
.
Further large-scale studies are needed to confirm this finding in the future
.
.
In addition, after adjuvant radiotherapy, the risk of accelerated CAC load in patients with left BC was significantly higher than that of patients with right BC
.
In addition, reducing the average RCA dose can reduce the risk of accelerated CAC load in BC patients by more than 50%
.
Further large-scale studies are needed to confirm this finding in the future
.
Original source:
Lai et al.
Accelerated coronary calcium burden in breast cancer patients after radiotherapy: a comparison with age and race matched healthy women.
Radiat Oncol (2021) 16:210
https://doi.
org/10.
1186/s13014-021-01936-w