Rehammar Jens Christian, Jensen Maj-Britt, McGale Paul, Lorenzen Ebbe Laugaard, Taylor Carolyn, Darby Sarah C, Videbæk Lars, Wang Zhe, Ewertz Marianne
Department of Oncology, Odense University Hospital, Denmark; Institute of Clinical Research, University of Southern Denmark, Denmark.
Danish Breast Cancer Cooperative Group Secretariat, Copenhagen University Hospital, Rigshospitalet, Denmark.
Radiother Oncol. 2017 May;123(2):299-305. doi: 10.1016/j.radonc.2017.03.012. Epub 2017 Mar 30.
The risk of heart disease subsequent to breast cancer radiotherapy was examined with particular focus on women receiving anthracycline-containing chemotherapy.
Women diagnosed with early-stage breast cancer in Denmark, 1977-2005, were identified from the register of the Danish Breast Cancer Cooperative Group, as was information on cancer-directed treatment. Information on heart disease was sought from the Danish National Patient and Cause of Death Registries. Incidence rate ratios were estimated comparing left-sided with right-sided cancer (IRR, LvR), stratified by calendar year, age, and time since breast cancer radiotherapy.
Among 19,464 women receiving radiotherapy, the IRR, LvR, was 1.11 (95% CI 1.03-1.20, p=0.005) for all heart disease and among those also receiving anthracyclines the IRR, LvR, was 1.32 (95% CI 1.02-1.70, p=0.03). This risk was highest if the treatment was given before the age of 50years (IRR, LvR, 1.44, (95% CI 1.04-2.01) but there was no significant trend with age or time since treatment.
Radiotherapy for left-sided breast cancer is associated with a higher risk of heart disease than for right-sided with the largest increases seen in women who also received anthracycline-containing chemotherapy.
研究乳腺癌放疗后发生心脏病的风险，特别关注接受含蒽环类化疗的女性。
从丹麦乳腺癌合作组织的登记册中识别出1977 - 2005年在丹麦被诊断为早期乳腺癌的女性，以及有关癌症针对性治疗的信息。从丹麦国家患者和死亡原因登记处获取心脏病信息。通过比较左侧与右侧癌症的发病率比值（IRR，左对右）进行估计，按日历年、年龄和乳腺癌放疗后的时间分层。
在19464名接受放疗的女性中，所有心脏病的IRR（左对右）为1.11（95%可信区间1.03 - 1.20，p = 0.005），在同时接受蒽环类药物治疗的女性中，IRR（左对右）为1.32（95%可信区间1.02 - 1.70，p = 0.03）。如果在50岁之前接受治疗，这种风险最高（IRR，左对右，1.44，（95%可信区间1.04 - 2.01），但未观察到随年龄或治疗后时间的显著趋势。
左侧乳腺癌放疗比右侧乳腺癌放疗患心脏病的风险更高，在同时接受含蒽环类化疗的女性中增加最为明显。
