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Modern Radiation Therapy and Cardiac Outcomes in Breast Cancer.
- Source :
-
International Journal of Radiation Oncology, Biology, Physics . Mar2016, Vol. 94 Issue 4, p700-708. 9p. - Publication Year :
- 2016
-
Abstract
- <bold>Purpose: </bold>Adjuvant radiation therapy, which has proven benefit against breast cancer, has historically been associated with an increased incidence of ischemic heart disease. Modern techniques have reduced this risk, but a detailed evaluation has not recently been conducted. The present study evaluated the effect of current radiation practices on ischemia-related cardiac events and procedures in a population-based study of older women with nonmetastatic breast cancer.<bold>Methods and Materials: </bold>A total of 29,102 patients diagnosed from 2000 to 2009 were identified from the Surveillance, Epidemiology, and End Results-Medicare database. Medicare claims were used to identify the radiation therapy and cardiac outcomes. Competing risk models were used to assess the effect of radiation on these outcomes.<bold>Results: </bold>Patients with left-sided breast cancer had a small increase in their risk of percutaneous coronary intervention (PCI) after radiation therapy-the 10-year cumulative incidence for these patients was 5.5% (95% confidence interval [CI] 4.9%-6.2%) and 4.5% (95% CI 4.0%-5.0%) for right-sided patients. This risk was limited to women with previous cardiac disease. For patients who underwent PCI, those with left-sided breast cancer had a significantly increased risk of cardiac mortality with a subdistribution hazard ratio of 2.02 (95% CI 1.23-3.34). No other outcome, including cardiac mortality for the entire cohort, showed a significant relationship with tumor laterality.<bold>Conclusions: </bold>For women with a history of cardiac disease, those with left-sided breast cancer who underwent radiation therapy had increased rates of PCI and a survival decrement if treated with PCI. The results of the present study could help cardiologists and radiation oncologists better stratify patients who need more aggressive cardioprotective techniques. [ABSTRACT FROM AUTHOR]
- Subjects :
- *CANCER radiotherapy
*HEALTH outcome assessment
*BREAST cancer treatment
*HEART physiology
*MEDICAL research
*ARRHYTHMIA diagnosis
*CORONARY heart disease complications
*HEART disease related mortality
*HEART diseases
*THERAPEUTICS
*ARRHYTHMIA
*CARDIOVASCULAR system
*CONFIDENCE intervals
*CORONARY disease
*REPORTING of diseases
*HEART
*MEDICAL care
*MEDICARE
*RESEARCH funding
Subjects
Details
- Language :
- English
- ISSN :
- 03603016
- Volume :
- 94
- Issue :
- 4
- Database :
- Academic Search Index
- Journal :
- International Journal of Radiation Oncology, Biology, Physics
- Publication Type :
- Academic Journal
- Accession number :
- 113255259
- Full Text :
- https://doi.org/10.1016/j.ijrobp.2015.12.018