Risk of cardiotoxicity induced by adjuvant anthracycline-based chemotherapy and radiotherapy in young and old Asian women with breast cancer

貢獻的翻譯標題: Risiko der Kardiotoxizität induziert durch adjuvante anthrazyklinbasierte Chemotherapie und Strahlentherapie bei jungen und alten asiatischen Frauen mit Brustkrebs

研究成果: 雜誌貢獻文章

摘要

Purpose: The risk of cardiotoxicity induced by adjuvant anthracycline-based chemotherapy (CT) and radiotherapy (RT) is yet to be investigated in a large-scale randomized controlled trial with an adequate sample size of young and old women with breast cancer. Patients and methods: To compare the occurrence of major heart events (heart failure and coronary artery disease) in patients with breast cancer, 3489 women who underwent surgical resection of the breast tumor were retrospectively selected from the Taiwan National Health Insurance Research Database. The patients were categorized into the following groups based on their treatment modalities: group 1 (n = 1113), no treatment; group 2 (n = 646), adjuvant RT alone; group 3 (n = 705), adjuvant anthracycline-based CT alone; and group 4 (n = 1025), combined adjuvant RT and anthracycline-based CT. Results: The mean patient age was 50.35 years. Subsequent coronary artery disease and heart failure were identified in 244 (7.0%) and 206 (5.9%) patients, respectively. All three adjuvant therapies were significant independent prognostic factors of major heart events (adjusted hazard ratio [95% confidence interval]: 1.47 [1.24–1.73]; 1.48 [1.25–1.75], and 1.92 [1.65–2.23] in groups 2, 3, and 4, respectively). In patients aged ≥50 years with breast cancer who underwent surgery, the log-rank p values of groups 2 and 3 after adjustment were 0.537 and 0.001, respectively. Conclusion: Adjuvant RT can increase cardiotoxicity in patients with breast cancer, particularly when used in combination with anthracycline-based CT. Therefore, it should be offered with optimal heart-sparing techniques, particularly in younger patients with good prognosis and long life expectancy.
原文英語
期刊Strahlentherapie und Onkologie
DOIs
出版狀態已發佈 - 一月 28 2019

指紋

Anthracyclines
Radiotherapy
Breast Neoplasms
Drug Therapy
Adjuvant Radiotherapy
Coronary Artery Disease
Heart Failure
Cardiotoxicity
National Health Programs
Life Expectancy
Taiwan
Sample Size
Therapeutics
Randomized Controlled Trials
Databases
Confidence Intervals
Research

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Oncology

引用此文

@article{9c93a300c6494d68b84780673f2d66da,
title = "Risk of cardiotoxicity induced by adjuvant anthracycline-based chemotherapy and radiotherapy in young and old Asian women with breast cancer",
abstract = "Purpose: The risk of cardiotoxicity induced by adjuvant anthracycline-based chemotherapy (CT) and radiotherapy (RT) is yet to be investigated in a large-scale randomized controlled trial with an adequate sample size of young and old women with breast cancer. Patients and methods: To compare the occurrence of major heart events (heart failure and coronary artery disease) in patients with breast cancer, 3489 women who underwent surgical resection of the breast tumor were retrospectively selected from the Taiwan National Health Insurance Research Database. The patients were categorized into the following groups based on their treatment modalities: group 1 (n = 1113), no treatment; group 2 (n = 646), adjuvant RT alone; group 3 (n = 705), adjuvant anthracycline-based CT alone; and group 4 (n = 1025), combined adjuvant RT and anthracycline-based CT. Results: The mean patient age was 50.35 years. Subsequent coronary artery disease and heart failure were identified in 244 (7.0{\%}) and 206 (5.9{\%}) patients, respectively. All three adjuvant therapies were significant independent prognostic factors of major heart events (adjusted hazard ratio [95{\%} confidence interval]: 1.47 [1.24–1.73]; 1.48 [1.25–1.75], and 1.92 [1.65–2.23] in groups 2, 3, and 4, respectively). In patients aged ≥50 years with breast cancer who underwent surgery, the log-rank p values of groups 2 and 3 after adjustment were 0.537 and 0.001, respectively. Conclusion: Adjuvant RT can increase cardiotoxicity in patients with breast cancer, particularly when used in combination with anthracycline-based CT. Therefore, it should be offered with optimal heart-sparing techniques, particularly in younger patients with good prognosis and long life expectancy.",
keywords = "Anthracycline, Breast cancer, Cardiotoxicity, Old, Radiotherapy",
author = "Lee, {Chih Hsin} and Zhang, {Jun Fu} and Yuan, {Kevin Sheng Po} and Wu, {Alexander T.H.} and Wu, {Szu Yuan}",
year = "2019",
month = "1",
day = "28",
doi = "10.1007/s00066-019-01428-7",
language = "English",
journal = "Strahlentherapie und Onkologie",
issn = "0179-7158",
publisher = "Urban und Vogel",

}

TY - JOUR

T1 - Risk of cardiotoxicity induced by adjuvant anthracycline-based chemotherapy and radiotherapy in young and old Asian women with breast cancer

AU - Lee, Chih Hsin

AU - Zhang, Jun Fu

AU - Yuan, Kevin Sheng Po

AU - Wu, Alexander T.H.

AU - Wu, Szu Yuan

PY - 2019/1/28

Y1 - 2019/1/28

N2 - Purpose: The risk of cardiotoxicity induced by adjuvant anthracycline-based chemotherapy (CT) and radiotherapy (RT) is yet to be investigated in a large-scale randomized controlled trial with an adequate sample size of young and old women with breast cancer. Patients and methods: To compare the occurrence of major heart events (heart failure and coronary artery disease) in patients with breast cancer, 3489 women who underwent surgical resection of the breast tumor were retrospectively selected from the Taiwan National Health Insurance Research Database. The patients were categorized into the following groups based on their treatment modalities: group 1 (n = 1113), no treatment; group 2 (n = 646), adjuvant RT alone; group 3 (n = 705), adjuvant anthracycline-based CT alone; and group 4 (n = 1025), combined adjuvant RT and anthracycline-based CT. Results: The mean patient age was 50.35 years. Subsequent coronary artery disease and heart failure were identified in 244 (7.0%) and 206 (5.9%) patients, respectively. All three adjuvant therapies were significant independent prognostic factors of major heart events (adjusted hazard ratio [95% confidence interval]: 1.47 [1.24–1.73]; 1.48 [1.25–1.75], and 1.92 [1.65–2.23] in groups 2, 3, and 4, respectively). In patients aged ≥50 years with breast cancer who underwent surgery, the log-rank p values of groups 2 and 3 after adjustment were 0.537 and 0.001, respectively. Conclusion: Adjuvant RT can increase cardiotoxicity in patients with breast cancer, particularly when used in combination with anthracycline-based CT. Therefore, it should be offered with optimal heart-sparing techniques, particularly in younger patients with good prognosis and long life expectancy.

AB - Purpose: The risk of cardiotoxicity induced by adjuvant anthracycline-based chemotherapy (CT) and radiotherapy (RT) is yet to be investigated in a large-scale randomized controlled trial with an adequate sample size of young and old women with breast cancer. Patients and methods: To compare the occurrence of major heart events (heart failure and coronary artery disease) in patients with breast cancer, 3489 women who underwent surgical resection of the breast tumor were retrospectively selected from the Taiwan National Health Insurance Research Database. The patients were categorized into the following groups based on their treatment modalities: group 1 (n = 1113), no treatment; group 2 (n = 646), adjuvant RT alone; group 3 (n = 705), adjuvant anthracycline-based CT alone; and group 4 (n = 1025), combined adjuvant RT and anthracycline-based CT. Results: The mean patient age was 50.35 years. Subsequent coronary artery disease and heart failure were identified in 244 (7.0%) and 206 (5.9%) patients, respectively. All three adjuvant therapies were significant independent prognostic factors of major heart events (adjusted hazard ratio [95% confidence interval]: 1.47 [1.24–1.73]; 1.48 [1.25–1.75], and 1.92 [1.65–2.23] in groups 2, 3, and 4, respectively). In patients aged ≥50 years with breast cancer who underwent surgery, the log-rank p values of groups 2 and 3 after adjustment were 0.537 and 0.001, respectively. Conclusion: Adjuvant RT can increase cardiotoxicity in patients with breast cancer, particularly when used in combination with anthracycline-based CT. Therefore, it should be offered with optimal heart-sparing techniques, particularly in younger patients with good prognosis and long life expectancy.

KW - Anthracycline

KW - Breast cancer

KW - Cardiotoxicity

KW - Old

KW - Radiotherapy

UR - http://www.scopus.com/inward/record.url?scp=85060716529&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85060716529&partnerID=8YFLogxK

U2 - 10.1007/s00066-019-01428-7

DO - 10.1007/s00066-019-01428-7

M3 - Article

AN - SCOPUS:85060716529

JO - Strahlentherapie und Onkologie

JF - Strahlentherapie und Onkologie

SN - 0179-7158

ER -