Is the risk of ischemic heart disease in women after radiotherapy for breast cancer nowadays still (linearly) associated with the mean heart dose?

Authors

  • Henk Struikmans Department of Radiation Therapy, Haaglanden Medical Center, Leidschendam, The Netherlands
  • Anna Petoukhova Department of Medical Physics, Haaglanden Medical Center, Leidschendam, the Netherlands
  • Joop H.M. Schreur Cardiology Department, Haaglanden Medical Center, Leidschendam, The Netherlands
  • Mirjam E. Mast Department of Radiation Therapy, Haaglanden Medical Center, Leidschendam, The Netherlands
  • Philip M. Poortmans Department of Radiation Oncology, Iridium Netwerk, Wilrijk-Antwerp, Belgium; Antwerp University, Wilrijk-Antwerp, Belgium

DOI:

https://doi.org/10.2340/1651-226X.2024.34751

Keywords:

Breast cancer, radiotherapy, mean heart dose, major coronary events

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References

Darby SC, McGale P, Taylor CW, Peto R. Long-term mortality from heart disease and lung cancer after radiotherapy for early breast cancer: prospective cohort study of about 300,000 women in US SEER cancer registries. Lancet Oncol. 2005;6:557–65.

https://doi.org/10.1016/S1470-2045(05)70251-5 DOI: https://doi.org/10.1016/S1470-2045(05)70251-5

Darby SC, Ewertz M, McGale P, et al. Risk of ischemic heart disease in women after radiotherapy for breast cancer. N Engl J Med. 2013;368:987–98.

https://doi.org/10.1056/NEJMoa1209825 DOI: https://doi.org/10.1056/NEJMoa1209825

Jacobse JN, Duane FK, Boekel NB, et al. Radiation dose-response for risk of myocardial infarction in breast cancer survivors. Int J Radiat Oncol Biol Phys. 2019;103(3):595–604.

https://doi.org/10.1016/j.ijrobp.2018.10.025 DOI: https://doi.org/10.1016/j.ijrobp.2018.10.025

van den Bogaard VAB, Ta BDP, van der Schaaf A, et al. Validation and modification of a prediction model for acute cardiac events in patients with breast cancer treated with radiotherapy based on three-dimensional dose distributions to cardiac substructures. J Clin Oncol. 2017;35(11):1171–8.

https://doi.org/10.1200/JCO.2016.69.8480 DOI: https://doi.org/10.1200/JCO.2016.69.8480

Lorenzen EL, Rehammar JC, Jensen MB, Ewertz M, Brink C. Radiation-induced risk of ischemic heart disease following breast cancer radiotherapy in Denmark, 1977–2005. Radiother Oncol. 2020;152:103–10.

https://doi.org/10.1016/j.radonc.2020.08.007 DOI: https://doi.org/10.1016/j.radonc.2020.08.007

Mutter RW, Choi I, Jimenez RB, et al. Proton therapy for breast cancer: a consensus statement from the particle therapy cooperative group breast cancer subcommittee. Int J Radiat Oncol Biol Phys. 2021;111(2):337–59.

https://doi.org/10.1016/j.ijrobp.2021.05.110 DOI: https://doi.org/10.1016/j.ijrobp.2021.05.110

National Guideline Alliance (UK). Evidence reviews for breast radiotherapy: early and locally advanced breast cancer: diagnosis and management: evidence review H [Internet]. London: National Institute for Health and Care Excellence (NICE); 2018 Jul. (NICE Guideline, No. 101.) [Cited date: 30-11-2023] Available from: https://www.ncbi.nlm.nih.gov/books/NBK576827/

Stick LB, Lorenzen EL, Yates ES, et al. Selection criteria for early breast cancer patients in the DBCG-proton trial – the randomised phase III trial strategy. Clin Transl Radiat Oncol. 2021;27:126–31.

https://doi.org/10.1016/j.ctro.2021.01.012 DOI: https://doi.org/10.1016/j.ctro.2021.01.012

Baaken D, Merzenich H, Schmidt M, et al. A nested case-control study on radiation dose-response for cardiac events in breast cancer patients in Germany. Breast. 2022;65:1–7.

https://doi.org/10.1016/j.breast.2022.05.007 DOI: https://doi.org/10.1016/j.breast.2022.05.007

Holm Milo ML, Slot Møller D, Bisballe Nyeng T, et al. Radiation dose to heart and cardiac substructures and risk of coronary artery disease in early breast cancer patients: a DBCG study based on modern radiation therapy techniques. Radiother Oncol. 2023;180:109453.

https://doi.org/10.1016/j.radonc.2022.109453 DOI: https://doi.org/10.1016/j.radonc.2022.109453

Duane FK, Boekel NB, Jacobse JN, et al. Exposure of the heart and cardiac valves in women irradiated for breast cancer 1970–2009. Clin Transl Radiat Oncol. 2022;36:132–9.

https://doi.org/10.1016/j.ctro.2022.07.004 DOI: https://doi.org/10.1016/j.ctro.2022.07.004

Taylor CW, Wang Z, Macaulay E, Jagsi R, Duane F, Darby SC. Exposure of the heart in breast cancer radiation therapy: a systematic review of heart doses published during 2003 to 2013. Rev Int J Radiat Oncol Biol Phys. 2015;93(4):845–53.

https://doi.org/10.1016/j.ijrobp.2015.07.2292 DOI: https://doi.org/10.1016/j.ijrobp.2015.07.2292

WHO Mortality Database. Notes: Data are age-standardised to the 2013 European standard population [Internet]. Available from: [Cited date: 30-11-2023] http://apps.who.int/healthinfo/statistics/mortality/whodpms/

Visseren FLJ, Mach F, Smulders YM, et al. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J. 2021;42(34):3227–37.

https://doi.org/10.1093/eurheartj/ehab484 DOI: https://doi.org/10.1093/eurheartj/ehab484

Kesteloot H, Sans S, Kromhout D. Dynamics of cardiovascular and all-cause mortality in Western and Eastern Europe between 1970 and 2000. Eur Heart J. 2006;27:107–13.

https://doi.org/10.1093/eurheartj/ehi511 DOI: https://doi.org/10.1093/eurheartj/ehi511

Hooning MJ, Botma A, Aleman BM, et al. Long-term risk of cardiovascular disease in 10-years survivors of breast cancer. J Natl Cancer Inst. 2007;99:365–75.

https://doi.org/10.1093/jnci/djk064 DOI: https://doi.org/10.1093/jnci/djk064

Taylor C, Correa C, Duane FK, et al. Estimating the risks of breast cancer radiotherapy: evidence from modern radiation doses to the lungs and heart and from previous randomized trials. J Clin Oncol 2017;35(15):1641–9.

https://doi.org/10.1200/JCO.2016.72.0722 DOI: https://doi.org/10.1200/JCO.2016.72.0722

Mehta LS, Watson KE, Barac A, et al. Cardio-vascular disease and breast cancer: where these entities intersect: a scientific statement from the American Heart Association. Circulation. 2018;137(8):e30–66.

https://doi.org/10.1161/CIR.0000000000000556 DOI: https://doi.org/10.1161/CIR.0000000000000556

Bogers SLC, Petoukhova AL, Penninkhof JJ, et al. Target volume coverage and organ at risk doses for left-sided whole breast irradiation with or without internal mammary chain irradiation: a comparison between 3 techniques representing the past and the present. Clin Oncol (R Coll Radiol). 2022;34(8):537–44.

https://doi.org/10.1016/j.clon.2022.04.004 DOI: https://doi.org/10.1016/j.clon.2022.04.004

Ranger A, Dunlop A, Hutchinson K, et al. A Dosimetric comparison of breast radiotherapy techniques to treat locoregional lymph nodes including the internal mammary chain. Clin Oncol (R Coll Radiol). 2018;30(6):346–53.

https://doi.org/10.1016/j.clon.2018.01.017 DOI: https://doi.org/10.1016/j.clon.2018.01.017

Overgaard M, Nielsen HM, Tramm T, et al. Postmastectomy radiotherapy in high-risk breast cancer patients given adjuvant systemic therapy. A 30-year long-term report from the Danish breast cancer cooperative group DBCG 82bc trial. Radiother Oncol. 2022;170:4–13.

https://doi.org/10.1016/j.radonc.2022.03.008 DOI: https://doi.org/10.1016/j.radonc.2022.03.008

EBCTCG. Radiotherapy to regional nodes in early breast cancer: an individual patient data meta-analysis of 14 324 women in 16 trials. Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) Lancet. 2023;402(10416):1991–2003.

https://doi.org/10.1016/S0140-6736(23)01082-6 DOI: https://doi.org/10.1016/S0140-6736(23)01082-6

Poortmans PM, Struikmans H, de Brouwer P, et al. Side effects 15-years after lymph node irradiation in breast cancer: randomized EORTC Trial 22922/10925. J Natl Cancer Inst. 2021;113(10):1360–8.

https://doi.org/10.1093/jnci/djab113 DOI: https://doi.org/10.1093/jnci/djab113

Mast ME, van Kempen-Harteveld L, et al. Left-sided breast cancer radiotherapy with and without breath-hold: does IMRT reduce the cardiac dose even further? Radiother Oncol. 2013;108(2):248–53.

https://doi.org/10.1016/j.radonc.2013.07.017 DOI: https://doi.org/10.1016/j.radonc.2013.07.017

Bentzen SM, Agrawal RK, Aird EG, et al. The UK standardisation of breast radiotherapy (START) trial B of radiotherapy hypofractionation for treatment of early breast cancer: a randomised trial. Lancet. 2008;371(9618):1098–107.

https://doi.org/10.1016/S0140-6736(08)60348-7 DOI: https://doi.org/10.1016/S0140-6736(08)60348-7

Brunt AM, Haviland JS, Wheatley DA, et al. Hypofractionated breast radiotherapy for 1 week versus 3 weeks (FAST-Forward): 5-year efficacy and late normal tissue effects results from a multicentre, non-inferiority, randomised, phase 3 trial. Lancet. 2020;395(10237):1613–26.

https://doi.org/10.1016/S0140-6736(20)30932-6 DOI: https://doi.org/10.1016/S0140-6736(20)30932-6

Taylor CW, Povall JM, McGale P, et al. Cardiac dose from tangential breast cancer radiotherapy in the year 2006. Int J Radiat Oncol Biol Phys. 2008;72:501–7.

https://doi.org/10.1016/j.ijrobp.2007.12.058 DOI: https://doi.org/10.1016/j.ijrobp.2007.12.058

Published

2024-04-10

How to Cite

Struikmans, H., Petoukhova, A., Schreur, J. H., Mast, M. E., & Poortmans, P. M. (2024). Is the risk of ischemic heart disease in women after radiotherapy for breast cancer nowadays still (linearly) associated with the mean heart dose?. Acta Oncologica, 63(1), 175–178. https://doi.org/10.2340/1651-226X.2024.34751