The Importance of Radiation Dose to the Atherosclerotic Plaque in the Left Anterior Descending Coronary Artery for Radiation-Induced Cardiac Toxicity of Breast Cancer Patients?

• DOI: 10.1016/j.ijrobp.2021.03.004
• Publication Date: 2021-03-11T03:21:22Z
• Authors: Veerle A.B. van d...; Daan S. Spoor; Arjen van der Schaaf; Lisanne V. van Dijk; Ewoud Schuit; Nanna M. Sijtsema; Johannes A. Lange...; John H. Maduro; Anne P.G. Crijns
• Keywords: Coronary arteries; Cumulative incidence

PurposeRadiation-induced acute coronary events (ACEs) may occur as a treatment-related late adverse effect of breast cancer (BC) radiation. However, the underlying mechanisms behind this radiation-induced cardiac disease remain to be determined. The objective study was test hypothesis that radiation dose calcified atherosclerotic plaques in left anterior descending artery (LAD) is better predictor for ACEs than whole heart or ventricle patients with BC treated therapy.Methods and MaterialsThe cohort consisted 910 postoperative therapy after breast-conserving surgery. In total, 163 had an plaque LAD. endpoint occurrence ACE treatment. For each individual patient, mean dose, volume receiving ≥5 Gy (LV-V5), LAD LAD, if present, were acquired based on planning computed tomography scans. Cox regression analysis used analyze effects cumulative incidence ACEs.ResultsThe median follow-up time 9.2 years (range, 0.1-14.3 years). 38 (4.2%) developed during follow-up. (n = 163), strongest ACEs, even correction cardiovascular risk factors (hazard ratio [HR], 1.269; 95% CI, 1.090-1.477; P .002). LV-V5 associated without 680) (HR, 1.021; 1.003-1.039; .023).ConclusionsThe results suggest pre-existing strongly development BC. Radiation-induced therapy. ACEs. .023).