International Journal of Radiation Oncology * Biology * Physics
Volume 73, Issue 4 , Pages 1061-1068 , 15 March 2009

Estimating Cardiac Exposure From Breast Cancer Radiotherapy in Clinical Practice

  • C.W. Taylor, F.R.C.R.

      Affiliations

    • Clinical Trial Service Unit, Oxford, United Kingdom
    • Corresponding Author InformationReprint requests to: C. W. Taylor, F.R.C.R., Clinical Trial Service Unit, Richard Doll Building, Roosevelt Dr., Oxford OX3 7LF United Kingdom. Tel: +44 1865 743950; Fax: +44 1865 743985
    • ,
  • P. McGale, Ph.D.

      Affiliations

    • Clinical Trial Service Unit, Oxford, United Kingdom
    • ,
  • J.M. Povall, M.Sc.

      Affiliations

    • Yorkshire Centre for Clinical Oncology, St. James's Institute of Oncology, St. James's Hospital, Leeds, United Kingdom
    • ,
  • E. Thomas, F.R.C.R.

      Affiliations

    • Yorkshire Centre for Clinical Oncology, St. James's Institute of Oncology, St. James's Hospital, Leeds, United Kingdom
    • ,
  • S. Kumar, F.R.C.R.

      Affiliations

    • Yorkshire Centre for Clinical Oncology, St. James's Institute of Oncology, St. James's Hospital, Leeds, United Kingdom
    • ,
  • D. Dodwell, M.D.

      Affiliations

    • Yorkshire Centre for Clinical Oncology, St. James's Institute of Oncology, St. James's Hospital, Leeds, United Kingdom
    • ,
  • S.C. Darby, Ph.D.

      Affiliations

    • Clinical Trial Service Unit, Oxford, United Kingdom

Received 19 April 2008 ,Revised 12 May 2008 ,Accepted 13 May 2008.

References 

  1. Early Breast Cancer Trialists' Collaborative Group. Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: An overview of the randomised trials. Lancet. 2005;366:2087–2106
  2. Darby SC, McGale P, Taylor CW, et al. Long-term mortality from heart disease and lung cancer after radiotherapy for early breast cancer: Prospective cohort study of about 300 000 women in US SEER cancer registries. Lancet Oncol. 2005;6:557–565
  3. Darby S, McGale P, Peto R, et al. Mortality from cardiovascular disease more than 10 years after radiotherapy for breast cancer: Nationwide cohort study of 90 000 Swedish women. BMJ. 2003;326:256–257
  4. Rutqvist LE, Lax I, Fornander T, et al. Cardiovascular mortality in a randomized trial of adjuvant radiation therapy versus surgery alone in primary breast cancer. Int J Radiat Oncol Biol Phys. 1992;22:887–896
  5. Gagliardi G, Lax I, Ottolenghi A, et al. Long-term cardiac mortality after radiotherapy of breast cancer—Application of the relative seriality model. Br J Radiol. 1996;69:839–846
  6. Carr ZA, Land CE, Kleinerman RA, et al. Coronary heart disease after radiotherapy for peptic ulcer disease. Int J Radiat Oncol Biol Phys. 2005;61:842–850
  7. Schultz-Hector S, Trott K-R. Radiation-induced cardiovascular diseases: Is the epidemiologic evidence compatible with the radiobiologic data?. Int J Radiat Oncol Biol Phys. 2007;67:10–18
  8. Schuster EH, Griffith LS, Bulkley BH. Preponderance of acute proximal left anterior descending coronary arterial lesions in fatal myocardial infarction: A clinicopathologic study. Am J Cardiol. 1981;47:1189–1196
  9. Karha J, Murphy SA, Kirtane AJ, et al. Evaluation of the association of proximal coronary culprit artery lesion location with clinical outcomes in acute myocardial infarction. Am J Cardiol. 2003;92:913–918
  10. Radiation Associated Cardiac Events (RACE). European Commission Contract 012796(FI6R). Available from: www.race.ki.se. Accessed April 10, 2008.
  11. Early Breast Cancer Trialists' Collaborative Group (EBCTCG). Available from: http://www.ctsu.ox.ac.uk/projects/ebctcg. Accessed April 10, 2008.
  12. Taylor CW, Povall JM, McGale P, et al. Cardiac dose from contemporary tangential breast cancer radiotherapy. Int J Radiat Oncol Biol Phys. 2008;72:501–507
  13. Gyenes G, Gagliardi G, Lax I, et al. Evaluation of irradiated heart volumes in stage I breast cancer patients treated with postoperative adjuvant radiotherapy. J Clin Oncol. 1997;15:1348–1353
  14. Venables K, Miles EA, Deighton A, et al. Irradiation of the heart during tangential breast treatment: A study within the START trial. Br J Radiol. 2004;77:137–142
  15. Cooke S, Rattray G. Can virtual simulation of breast tangential portals accurately predict lung and heart volumes?. Australasian Radiol. 2003;47:37–43
  16. Taylor CW, Nisbet A, McGale P, et al. Cardiac exposures in breast cancer radiotherapy: 1950s–1990s. Int J Radiat Oncol Biol Phys. 2007;69:1484–1495
  17. Lauk S, Rüth S, Trott KR. The effects of dose-fractionation on radiation-induced heart disease in rats. Radiother Oncol. 1987;8:363–367
  18. Schultz-Hector S, Sund M, Thames HD. Fractionation response and repair kinetics of the radiation-induced heart failure in the rat. Radiother Oncol. 1992;23:33–40
  19. Hurkmans CW, Cho BCJ, Damen E, et al. Reduction of cardiac and lung complication probabilities after breast irradiation using conformal radiotherapy with or without intensity modulation. Radiother Oncol. 2002;62:163–171
  20. Kallman P, Agren A, Brahme A. Tumour and normal tissue responses to fractionated non-uniform dose delivery. Int J Radiat Biol. 1992;62:249–262
  21. Borger JH, Hooning MJ, Boersma LJ, et al. Cardiotoxic effects of tangential breast irradiation in early breast cancer patients: The role of irradiated heart volume. Int J Radiat Oncol Biol Phys. 2007;69:1131–1138
  22. Hughes KS, Schnaper LA, Berry D, et al. Lumpectomy plus tamoxifen with or without irradiation in women 70 years of age or older with early breast cancer. N Engl J Med. 2004;351:971–977
  23. Julien J-P, Bijker N, Fentiman IS, et al. Radiotherapy in breast-conserving treatment for ductal carcinoma in situ: First results of the EORTC randomised phase III trial 10853. Lancet. 2000;355:528–533

 Supported by Cancer Research UK and the Department of Health Radiation Protection Research Program, Grant RRX108.

 Conflict of interest: none.

PII: S0360-3016(08)02948-9

doi: 10.1016/j.ijrobp.2008.05.066

International Journal of Radiation Oncology * Biology * Physics
Volume 73, Issue 4 , Pages 1061-1068 , 15 March 2009

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