Marinko Tanja, Borstnar Simona, Blagus Rok, Dolenc Jure, Bilban-Jakopin Cvetka
Department of Radiation Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia.
Department of Medical Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia.
Radiol Oncol. 2018 Feb 25;52(2):204-212. doi: 10.2478/raon-2018-0011. eCollection 2018 Jun.
The purpose of the study was to find out whether there is a difference in the early parameters of cardiotoxicity (left ventricular ejection fraction [LVEF] and N-terminal pro-B-type natriuretic peptide [NT-proBNP]) between the two groups of patients: the patients treated for left breast cancer (left breast cancer group) and those treated for the right breast cancer (right breast cancer group), after the treatment had been completed.
The study included 175 consecutive patients with human epidermal growth factor receptor-2 (HER2) positive early breast cancer, treated concurrently with trastuzumab and radiotherapy (RT), between June 2005 and December 2010. Echocardiography with LVEF measurement was performed before adjuvant RT (LVEF) and after the completed treatment (LVEF,). After the treatment NT-proBNP measurement was done as well. The difference (Δ) between LVEF and LVEF was analysed (Δ LVEF = LVEF - LVEF) and compared between the two groups.
There were 84 patients in the left and 91 in the right breast cancer group. Median observation time was 57 (37-71) months. Mean Δ LVEF (%) was -1.786% in the left and -2.607% in the right breast cancer group (p = 0.562, CI: -2.004 to 3.648). Median NT-proBNP were 111.0 ng/l in the left and 90.0 ng/l in the right breast cancer group (p = 0.545). Echocardiography showed that the patients in the left breast cancer group did not have significantly worse systolic and diastolic left ventricular function in comparison with the patients in the right breast cancer group, but, they had higher incidence of pericardial effusion (9 [11%] vs. 1 [1%]) (p = 0.007).
We did not find any significant differences in the early parameters of cardiotoxicity (LVEF, NT-proBNP) between the observed groups. Patients who received left breast/chest wall irradiation had higher incidence of pericardial effusion.
本研究旨在探究两组患者（左侧乳腺癌患者组和右侧乳腺癌患者组）在完成治疗后，心脏毒性早期参数（左心室射血分数[LVEF]和N末端B型利钠肽原[NT-proBNP]）是否存在差异。
本研究纳入了2005年6月至2010年12月期间连续收治的175例人表皮生长因子受体2（HER2）阳性早期乳腺癌患者，这些患者同时接受曲妥珠单抗和放疗（RT）。在辅助放疗前（LVEF）和完成治疗后（LVEF）进行测量LVEF的超声心动图检查。治疗后也进行NT-proBNP测量。分析LVEF与LVEF之间的差值（Δ）（ΔLVEF = LVEF - LVEF）并在两组之间进行比较。
左侧乳腺癌组有84例患者，右侧乳腺癌组有91例患者。中位观察时间为57（37 - 71）个月。左侧乳腺癌组的平均ΔLVEF（%）为-1.786%，右侧乳腺癌组为-2.607%（p = 0.562，CI：-2.004至3.648）。左侧乳腺癌组的NT-proBNP中位数为111.0 ng/l，右侧乳腺癌组为90.0 ng/l（p = 0.545）。超声心动图显示，与右侧乳腺癌组患者相比，左侧乳腺癌组患者的左心室收缩和舒张功能并无显著更差，但心包积液的发生率更高（9例[11%]对1例[1%]）（p = 0.007）。
我们未发现观察组之间在心脏毒性早期参数（LVEF、NT-proBNP）上存在任何显著差异。接受左侧乳腺/胸壁照射的患者心包积液发生率更高。
