방사선종양학

  • [J Cardiol.] Cardiovascular outcome of breast cancer patients with concomitant radiotherapy and chemotherapy: A 10-year multicenter cohort study.

    한림의대 / 김도영, 윤종찬*, 이재진*, 한성우*

  • 출처
    J Cardiol.
  • 등재일
    2019 Aug
  • 저널이슈번호
    74(2):175-181. doi: 10.1016/j.jjcc.2019.02.001. Epub 2019 Mar 1.
  • 내용

    바로가기  >

     

    Abstract
    BACKGROUND:
    Cancer treatment increases the risk of cardiovascular (CV) events. However, the long-term CV outcome of breast cancer patients who undergo radiotherapy and chemotherapy concomitantly is unknown. This study aimed to determine the incidence and risk factors of CV events among these patients.

    METHODS:
    Six hundred sixty consecutive breast cancer patients older than 50 years from November 2005 to September 2015, were enrolled in four university hospitals. The primary endpoint was CV events including CV mortality, myocardial infarction, heart failure, and stroke. CV events occurred in 14 (2.1%) patients during the follow-up period (median, 47.1 months).

    RESULTS:
    Left-side irradiation was associated with increased risk of CV events in patients with doxorubicin dose ≥250mg/m2 but not in patients with doxorubicin dose <250mg/m2. On multivariable analysis, concomitant left-side irradiation with doxorubicin dose ≥250mg/m2 and hypertension were independent risk factors for CV events.

    CONCLUSION:
    The risk of CV events was further increased with concomitant left-side irradiation and doxorubicin ≥250mg/m2 in breast cancer patients.

     


    Author information

    Kim DY1, Youn JC2, Park MS3, Lee S3, Choi SW3, Ryu KH3, Kim LS4, Shim MS5, Lee JJ6, Han S7.
    1
    Division of Cardiology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea; Division of Cardiology, Korea University Anam Hospital, Seoul, Republic of Korea.
    2
    Division of Cardiology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea. Electronic address: jong.chan.youn@gmail.com.
    3
    Division of Cardiology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea.
    4
    Division of Breast and Endocrine Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea.
    5
    Department of Thoracic and Cardiovascular Surgery, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Republic of Korea.
    6
    Department of Thoracic and Cardiovascular Surgery, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Republic of Korea. Electronic address: jj58lee@hallym.or.kr.
    7
    Division of Cardiology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea. Electronic address: hansw29@hallym.or.kr.

  • 키워드
    Anthracycline; Breast cancer; Cardiovascular outcome; Chemotherapy; Radiotherapy
  • 편집위원

    국내에서 유방암 방사선치료 후 심혈관질환의 발생률을 분석한 논문으로, 고용량의 doxorubicin/좌측 유방 방사선치료와 고혈압이 유의한 영향인자로 분석되었음

    2019-09-27 14:20:26

  • 편집위원2

    후향적 연구이지만 좌측 유방암이면서 doxorubicin dose ≥250 mg/㎡에서 cardiovascular events가 증가한다는 연구결과는 doxorubicin 병용요법과 함께 heart 주위의 종양에 대해 방사선치료시 심혈관계 부작용에 대한 고려가 필요함을 제시합니다. 한가지 아쉬운점은 연구에 방사선종양학과 전문의가 참여하지 않아 RT technique, heart dose 등과 cardiovascular events의 상관관계가 분석되지 않았는데, 향후 선량분석을 통해 심혈관계 부작용과의 연관관계를 알아보는 연구가 필요하겠습니다.

    2019-09-27 14:20:57

  • 덧글달기
    덧글달기
       IP : 3.230.119.106

    등록