Oncological benefit versus cardiovascular risk in breast cancer patients treated with modern radiotherapy

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dc.article.number3889
dc.catalogadorpva
dc.contributor.authorAcevedo, Francisco
dc.contributor.authorIp, Teresa
dc.contributor.authorOrellana, María
dc.contributor.authorMartínez, Gonzalo
dc.contributor.authorGabrielli, Luigi
dc.contributor.authorAndia, Marcelo
dc.contributor.authorBesa, Cecilia
dc.contributor.authorPinto, Mauricio P.
dc.contributor.authorSánchez, Cesar
dc.contributor.authorMerino, Tomas
dc.date.accessioned2024-01-19T18:21:48Z
dc.date.available2024-01-19T18:21:48Z
dc.date.issued2022
dc.description.abstractRadiotherapy (RT) is an essential part of breast cancer (BC) treatments. Unfortunately, heart exposure to radiation can also impair the long-term survival of patients. Our study aimed to quantify the oncological benefit and the cardiovascular (CV) risk associated with modern RT in a real-world cohort of BC patients. Our descriptive study enrolled BC patients who received adjuvant RT. Ten-year overall survival (OS) was estimated using Predict® version 2.1 (National Health Service, London, UK). The basal risk of CV events was estimated using the American Heart Association (ACC/AHA) CV score. Treatment volumes and mean cardiac doses were obtained from RT treatment plan records. The increased risk of CV events due to RT was estimated using a model proposed by Darby. The risk of acute myocardial infarction or stroke mortality was estimated using HeartScore® (European Society of Cardiology, Brussels, Belgium). A total of 256 BC patients were included in the study. The average age of patients was 57 years old (range: 25–91); 49.6% had left BC. The mean cardiac dose was 166 cGy (interquartile range (IQR) 94–273); the estimated hazard ratio (HR) for CV disease was HR 1.12 (confidence interval (CI) 1.04–1.24). The estimated baseline 10-year CV risk was 5.6% (0.2 to 51.2); CV risk increased by 0.9% (range 0.02–35.47%) after RT. The absolute risk of 10-year mortality from CV disease was 2.5% (0.1–9); RT was associated with an estimated 4.9% survival benefit (3.73–6.07) against BC death and a 0.23% (0.17–0.29) estimated increase in CV mortality. Modern RT decreased 10-year BC mortality by 4% but increased CV mortality by 0.2% in this cohort. Our findings encourage the implementation of personalized adjuvant RT treatments that balance risks and benefits to improve long-term BC patient survival.
dc.fechaingreso.objetodigital2024-06-04
dc.fuente.origenORCID-ene24
dc.identifier.doi10.3390/jcm11133889
dc.identifier.urihttp://dx.doi.org/10.3390/jcm11133889
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/80797
dc.information.autorucEscuela de Medicina; Acevedo Claros, Francisco Nicolas; 0000-0003-3482-7746; 119540
dc.issue.numero13
dc.language.isoen
dc.nota.accesoContenido completo
dc.pagina.final10
dc.pagina.inicio1
dc.revistaJournal of Clinical Medicine
dc.rightsacceso abierto
dc.rights.licenseCC BY 4.0 DEED Attribution 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectRadiotherapy
dc.subjectBreast cancer
dc.subjectCardio-oncology
dc.subjectCardiovascular disease
dc.subject.ddc610
dc.subject.deweyMedicina y saludes_ES
dc.titleOncological benefit versus cardiovascular risk in breast cancer patients treated with modern radiotherapy
dc.typeartículo
dc.volumen11
sipa.codpersvinculados119540
sipa.trazabilidadORCID;2024-01-08
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