a Department of Radiotherapy , "A. Perrino" Hospital , Brindisi , Italy.
b Institute of Clinical Physiology , National Research Council (IFC-CNR) , Pisa , Italy.
Int J Radiat Biol. 2019 Feb;95(2):201-206. doi: 10.1080/09553002.2019.1542183. Epub 2018 Dec 3.
Left-sided breast cancer patients treated with radiotherapy (RT) are at risk for late radiation-induced cardiovascular complications.
The aim of this study was to investigate the BNP plasma levels in long-term breast cancer survivors who received only RT as well to assess whether cardiac dose was associated with BNP values.
Plasma samples for BNP measurement were repeated in 29 patients (63 ± 11 years) who were alive at 5 years after radiotherapy, free of heart disease and available to provide new blood sample. All patients had BNP measurements at baseline. The ΔBNP was measured to analyze the role of marker variations. No patients received chemotherapy.
The mean cardiac and ventricle dose were 2.1 ± 1.0 (range 0.02-4.5) Gy and 3.0 ± 1.7 (range 0.02-7.6), respectively. Median value of BNP was 47 pg/mL (interquartile ranges, 26-58.2 pg/mL) at baseline, and 34 pg/mL (interquartile ranges, 17.5-54 pg/mL) at 5 years after radiotherapy. There was no significantly different between two measurements (p = ns). Fifteen (52%) reported an improvement in BNP levels, 1 (3%) no changes and 13 (45%) reported a worsening. There was no correlation between ΔBNP and age (p = ns). When patients were stratified according to the median value of dose-volume data, ΔBNP was significantly higher in patients with increased cardiac D (p = .02) and left ventricle D (p = .009).
At 5 years after radiotherapy, median plasma BNP levels remained within the normal range, but the delta-BNP levels are directly related to the heart and ventricular dose received.
接受放射治疗(RT)的左侧乳腺癌患者有发生晚期放射性心血管并发症的风险。
本研究旨在调查仅接受 RT 治疗的长期乳腺癌幸存者的 BNP 血浆水平,并评估心脏剂量是否与 BNP 值相关。
对 29 例(63±11 岁)放射治疗后 5 年存活、无心脏病且可提供新血样的患者重复测量 BNP 血浆样本。所有患者均在基线时进行 BNP 测量。测量ΔBNP 以分析标志物变化的作用。没有患者接受化疗。
平均心脏和心室剂量分别为 2.1±1.0(范围 0.02-4.5)Gy 和 3.0±1.7(范围 0.02-7.6)。基线时 BNP 的中位数为 47pg/mL(四分位间距,26-58.2pg/mL),放射治疗 5 年后为 34pg/mL(四分位间距,17.5-54pg/mL)。两次测量之间无显著差异(p=ns)。15 例(52%)报告 BNP 水平改善,1 例(3%)无变化,13 例(45%)报告恶化。ΔBNP 与年龄之间无相关性(p=ns)。当根据剂量-体积数据的中位数对患者进行分层时,心脏 D(p=0.02)和左心室 D(p=0.009)增加的患者的ΔBNP 显著更高。
放射治疗 5 年后,中位血浆 BNP 水平仍在正常范围内,但ΔBNP 水平与心脏和心室接受的剂量直接相关。