Cardiac Dose Risk Stratification and Determinants of Radiation Exposure in Breast Cancer Patients Undergoing Advanced Radiotherapy: Cardiac Dose Risk Stratification and Determinants of Radiation Exposure

Iqra Iftikhar

Authors

Iqra Iftikhar INMOL Cancer Hospital, Lahore, Pakistan Author

Keywords:

Breast Neoplasms, Cardiovascular Diseases, Radiotherapy, Heart, Radiation Dosage, Cardiotoxicity, Risk Assessment, Mastectomy, Treatment Outcome, Retrospective Studies

Abstract

Background: Cardiac exposure during breast cancer radiotherapy is one of the well-known causes of late cardiovascular morbidity. The present secondary analysis was conducted with the aim of stratifying the risk of exposure to cardiac radiations and defining clinical and treatment specific determinants of increased cardiac dose among patients with breast cancer using three-dimensional conformal radiotherapy (3D-CRT). Methods: The treatment planning data of 126 female breast cancer patients given 3D-CRT in a tertiary cancer center was performed by secondary analysis. The Cardiac exposure was classified as being of low-, moderate-, and high-dose groups depending on clinically significant mean heart dose (MHD) exposure thresholds. The chi-square test, independent t-tests, and one-way ANOVA were used to test associations between cardiac dose category, laterality, surgical procedure and patient age with the level of statistical significance (p<0.05). Results: In general, patients who were classified within the moderate-high levels of cardiac exposure were 38.1%. The association between cardiac dose risk and left-sided breast cancer was significant as more than 85% of all the high-risk patients were identified to have left-sided treatment (p < 0.001). The type of surgery influences cardiac exposure since radical mastectomy was found to have a higher dose of risk than breast-conserving surgery (p < 0.001). Conclusion: This secondary review illustrates that there is no homogeneous distribution of cardiac radiation exposure during 3D-CRT but highly dependent on the tumor laterality and method of surgery as opposed to patient age.

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Author Biography

Iqra Iftikhar, INMOL Cancer Hospital, Lahore, Pakistan

Department of Radiation Oncology

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Cardiac Dose Risk Stratification and Determinants of Radiation Exposure in Breast Cancer Patients Undergoing Advanced Radiotherapy