Aslan Dicle, Ozoner Sadik, Inanc Mevlude, Yildiz Oguz Galip, Inanc Mehmet Tugrul
Department of Radiation Oncology, Erciyes University, Faculty of Medicine, 38140, Kayseri, Türkiye.
Department of Radiation Oncology, Mugla Education and Research Hospital, Mugla, Türkiye.
Ir J Med Sci. 2025 Feb;194(1):7-18. doi: 10.1007/s11845-024-03835-x. Epub 2024 Nov 4.
Overexpression of human epidermal growth factor receptor 2 (HER-2) is associated with aggressive disease in breast cancer. Trastuzumab and radiotherapy are standard treatments for patients with HER-2 + breast cancer, but they may increase the risk of cardiotoxicity.
This study aimed to assess early cardiotoxicity in patients receiving radiotherapy (RT) and concurrent trastuzumab.
The study included 116 patients with HER-2 + breast cancer who received concurrent treatment with trastuzumab and RT (52 right-side; 64 left-side). Five left ventricular ejection fraction (LVEF) measurements were performed: one before treatment and four subsequent measurements taken at three-month intervals. LVEF was also assessed before (preRT-EF) and after (postRT-EF) radiotherapy.
The baseline LVEF was 62.27 ± 5.5%, while the 12-month LVEF was 59.8 ± 5.8% (p < 0.05). In subgroups, post-RT LVEF values were significantly lower than pre-RT LVEF values (p < 0.05). No significant difference was found between the reduction in LVEF for patients receiving 50 Gy and 60 Gy doses. Moreover, the contribution of regional lymph node irradiation to the decrease in LVEF could not be demonstrated. A positive correlation was found between the total trastuzumab dose and the decrease in LVEF from preRT to postRT. Additionally, a positive correlation was observed between the total taxane dose and the reduction in LVEF from baseline to 9 months, both in the overall group and in the left breast cancer group.
In our study,it was found that not only trastuzumab but also taxane-based agents could be cardiotoxic. However, no connection was found between RT doses and the decrease in LVEF.
人表皮生长因子受体2（HER-2）的过表达与乳腺癌的侵袭性疾病相关。曲妥珠单抗和放疗是HER-2阳性乳腺癌患者的标准治疗方法，但它们可能会增加心脏毒性的风险。
本研究旨在评估接受放疗（RT）和同步曲妥珠单抗治疗的患者的早期心脏毒性。
该研究纳入了116例HER-2阳性乳腺癌患者，他们接受了曲妥珠单抗和RT的同步治疗（右侧52例；左侧64例）。进行了五次左心室射血分数（LVEF）测量：一次在治疗前，随后四次每隔三个月测量一次。还在放疗前（放疗前EF）和放疗后（放疗后EF）评估了LVEF。
基线LVEF为62.27±5.5%，而12个月时LVEF为59.8±5.8%（p<0.05）。在亚组中，放疗后LVEF值显著低于放疗前LVEF值（p<0.05）。接受50 Gy和60 Gy剂量的患者在LVEF降低方面未发现显著差异。此外，区域淋巴结照射对LVEF降低的影响无法得到证实。发现曲妥珠单抗总剂量与放疗前至放疗后LVEF降低之间存在正相关。此外，在总体组和左乳腺癌组中，均观察到紫杉烷总剂量与从基线到9个月LVEF降低之间存在正相关。
在我们的研究中，发现不仅曲妥珠单抗，而且紫杉烷类药物也可能具有心脏毒性。然而，未发现放疗剂量与LVEF降低之间存在关联。
