Marhin Wilson, Wai Elaine, Tyldesley Scott
Division of Radiation Oncology, Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada.
Int J Radiat Oncol Biol Phys. 2007 Oct 1;69(2):483-9. doi: 10.1016/j.ijrobp.2007.03.033. Epub 2007 Jul 2.
To determine whether fraction size affects the risk of cardiac mortality in women treated with adjuvant radiotherapy (RT) for left-sided breast cancer.
A population-based retrospective study of women with a diagnosis of localized breast cancer treated with adjuvant RT in British Columbia from 1984 to 2000. Cases were identified from the British Columbia Cancer Agency database. Overall and cardiac-specific survival were compared for women treated with RT for left- vs. right-sided breast cancer. We analyzed the impact of age (<or=60 vs. >60 years) at diagnosis and RT fraction size (<or=2 vs. >2 Gy) on risk of fatal cardiac events.
We identified 3,781 women with left-sided and 3,666 women with right-sided breast cancer who received adjuvant RT. Median follow-up was 7.9 years. There were 52 vs. 47 breast cancer deaths in women treated for left- and right-sided breast cancer, respectively. There was no significant difference in cardiac mortality for women <or=60 or >60 years of age who received adjuvant RT for left-sided vs. right-sided cancer. There was no difference in cardiac mortality for women who received adjuvant RT with fraction sizes <or=2 vs. >2 Gy for left- or right-sided cancer.
There was no evidence for increased risk of cardiac mortality in women treated with adjuvant RT after a median follow-up of 7.9 years in our cohort. Hypofractionated adjuvant RT regimens did not significantly increase the risk of cardiac mortality.
确定分次剂量是否会影响接受左侧乳腺癌辅助放疗（RT）的女性发生心脏死亡的风险。
对1984年至2000年在不列颠哥伦比亚省接受辅助放疗的局部乳腺癌女性患者进行基于人群的回顾性研究。病例来自不列颠哥伦比亚癌症机构数据库。比较接受左侧与右侧乳腺癌放疗的女性的总生存率和心脏特异性生存率。我们分析了诊断时年龄（≤60岁与＞60岁）和放疗分次剂量（≤2 Gy与＞2 Gy）对致命心脏事件风险的影响。
我们确定了3781例接受辅助放疗的左侧乳腺癌女性和3666例右侧乳腺癌女性。中位随访时间为7.9年。接受左侧和右侧乳腺癌治疗的女性分别有52例和47例乳腺癌死亡。接受左侧或右侧癌症辅助放疗的≤60岁或＞60岁女性的心脏死亡率无显著差异。接受辅助放疗且分次剂量≤2 Gy与＞2 Gy的左侧或右侧癌症女性的心脏死亡率无差异。
在我们的队列中，中位随访7.9年后，没有证据表明接受辅助放疗的女性心脏死亡风险增加。大分割辅助放疗方案并未显著增加心脏死亡风险。
