Honaryar Manoj Kumar, Allodji Rodrigue, Jimenez Gaelle, Lapeyre Mathieu, Panh Loic, Camilleri Jeremy, Broggio David, Ferrières Jean, De Vathaire Florent, Jacob Sophie
INSERM U 1018, CESP, Radiation Epidemiology Team, 94800 Villejuif, France.
Gustave Roussy, Research Department, 94800 Villejuif, France.
J Cardiovasc Dev Dis. 2023 Jul 12;10(7):299. doi: 10.3390/jcdd10070299.
Background-Radiotherapy (RT) for breast cancer (BC) can lead to an increased risk of coronary artery disease several years after RT. The aim of this study was to evaluate the development of overall, non-calcified and calcified atherosclerotic plaques over 2 years after BC for RT and associations with cardiac exposure. Methods-The study included 101 left- or right-sided BC patients treated with RT without chemotherapy. A coronary CT angiography was performed before and 2 years after RT. Plaque development thorough the entire coronary network was defined as an increased number of plaques. Cardiac exposure was quantified with mean doses to the heart, left ventricle, and coronary arteries. Logistic regression models were used to assess association with doses. Results-At inclusion, 37% of patients had plaques, increasing to 42% two years after RT. Overall plaque development was observed in seven patients: five with calcified plaque development and four with non-calcified plaque development. The risk of overall plaque development was significantly associated with doses to the Left Main and Circumflex coronary arteries (OR at 1 Gy = 2.32, = 0.03 and OR at 1 Gy = 2.27, = 0.03, respectively). Specific analyses for calcified and non-calcified plaque development showed similar results. Conclusion-Our study suggests an association between coronary arteries exposure and the risk of developing both calcified and non-calcified atherosclerotic plaques over 2 years after BC RT. Trial registration number: NCT02605512.
背景-乳腺癌放疗（RT）后数年，患冠状动脉疾病的风险会增加。本研究旨在评估乳腺癌放疗后2年内总体、非钙化和钙化动脉粥样硬化斑块的发展情况以及与心脏受照剂量的关联。方法-本研究纳入了101例接受放疗且未接受化疗的单侧乳腺癌患者。在放疗前和放疗后2年进行冠状动脉CT血管造影。整个冠状动脉网络中斑块的发展定义为斑块数量增加。用心脏、左心室和冠状动脉的平均剂量对心脏受照剂量进行量化。采用逻辑回归模型评估与剂量的关联。结果-纳入研究时，37%的患者有斑块，放疗后2年这一比例增至42%。观察到7例患者有总体斑块发展：5例有钙化斑块发展，4例有非钙化斑块发展。总体斑块发展的风险与左主干和回旋支冠状动脉的剂量显著相关（1 Gy时的OR分别为2.32，P = 0.03和1 Gy时的OR为2.27，P = 0.03）。钙化和非钙化斑块发展的具体分析显示了相似的结果。结论-我们的研究表明，乳腺癌放疗后2年内，冠状动脉受照与发生钙化和非钙化动脉粥样硬化斑块的风险之间存在关联。试验注册号：NCT02605512。
