Heart sparing radiotherapy in breast cancer: the importance of baseline cardiac risks
Background Patients with left-sided breast cancer have an increased risk of cardiovascular disease (CVD) after radiotherapy (RT). While the awareness of cardiac toxicity has increased enormously over the last decade, the role of individual baseline cardiac risks has not yet been systematically inves...
Ausführliche Beschreibung
Autor*in: |
Gaasch, Aurélie [verfasserIn] Schönecker, Stephan [verfasserIn] Simonetto, Cristoforo [verfasserIn] Eidemüller, Markus [verfasserIn] Pazos, Montserrat [verfasserIn] Reitz, Daniel [verfasserIn] Rottler, Maya [verfasserIn] Freislederer, Philipp [verfasserIn] Braun, Michael [verfasserIn] Würstlein, Rachel [verfasserIn] Harbeck, Nadia [verfasserIn] Niyazi, Maximilian [verfasserIn] Belka, Claus [verfasserIn] Corradini, Stefanie [verfasserIn] |
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Englisch |
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2020 |
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Übergeordnetes Werk: |
Enthalten in: Radiation oncology - London : BioMed Central, 2006, 15(2020), 1 vom: 24. Mai |
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Übergeordnetes Werk: |
volume:15 ; year:2020 ; number:1 ; day:24 ; month:05 |
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DOI / URN: |
10.1186/s13014-020-01520-8 |
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SPR03981744X |
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245 | 1 | 0 | |a Heart sparing radiotherapy in breast cancer: the importance of baseline cardiac risks |
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520 | |a Background Patients with left-sided breast cancer have an increased risk of cardiovascular disease (CVD) after radiotherapy (RT). While the awareness of cardiac toxicity has increased enormously over the last decade, the role of individual baseline cardiac risks has not yet been systematically investigated. Aim of the present study was to evaluate the impact of baseline CVD risks on radiation-induced cardiac toxicity. Methods Two hundred ten patients with left-sided breast cancer treated in the prospective Save-Heart Study using a deep inspiration breath-hold (DIBH) technique were analysed regarding baseline risk factors for CVD. Three frequently used prediction tools (Procam, Framingham and Reynolds score) were applied to evaluate the individual CVD risk profiles. Moreover, 10-year CVD excess absolute risks (EAR) were estimated using the individual mean heart dose (MHD) of treatment plans in free breathing (FB) and DIBH. Results The individual baseline CVD risk factors had a strong impact on the 10-year cumulative CVD risk. The mean baseline risks of the non-diabetic cohort (n = 200) ranged from 3.11 to 3.58%, depending on the risk estimation tool. A large number of the non-diabetic patients had a very low 10-year CVD baseline risk of ≤1%; nevertheless, 8–9% of patients reached ≥10% baseline 10-year CVD risk. In contrast, diabetic patients (n = 10) had significantly higher baseline CVD risks (range: 11.76–24.23%). The mean 10-year cumulative risk (Framingham score) following RT was 3.73% using the DIBH-technique (MHD:1.42Gy) and 3.94% in FB (MHD:2.33Gy), after adding a 10-year-EAR of + 0.34%(DIBH) and + 0.55%(FB) to the baseline risks, respectively. Smoking status was one of the most important and modifiable baseline risk factors. After DIBH-RT, the 182 non-smoking patients had a mean 10-year cumulative risk of 3.55% (3.20% baseline risk, 0.35% EAR) as compared to 6.07% (5.60% baseline risk, 0.47% EAR) for the 28 smokers. Conclusion In the present study, all CVD prediction tools showed comparable results and could easily be integrated into daily clinical practice. A systematic evaluation and screening helps to identify high-risk patients who may benefit from primary prevention. This could result in an even higher benefit than from heart-sparing irradiation techniques alone. | ||
650 | 4 | |a Breast cancer |7 (dpeaa)DE-He213 | |
650 | 4 | |a Breast conserving surgery |7 (dpeaa)DE-He213 | |
650 | 4 | |a Radiotherapy |7 (dpeaa)DE-He213 | |
650 | 4 | |a Heart sparing |7 (dpeaa)DE-He213 | |
650 | 4 | |a Deep inspiration breath hold (DIBH) |7 (dpeaa)DE-He213 | |
650 | 4 | |a Toxicity |7 (dpeaa)DE-He213 | |
650 | 4 | |a Radiation-induced risk |7 (dpeaa)DE-He213 | |
650 | 4 | |a Cardiovascular risk factors |7 (dpeaa)DE-He213 | |
650 | 4 | |a Cardiac risk |7 (dpeaa)DE-He213 | |
650 | 4 | |a Outcome |7 (dpeaa)DE-He213 | |
700 | 1 | |a Schönecker, Stephan |e verfasserin |4 aut | |
700 | 1 | |a Simonetto, Cristoforo |e verfasserin |4 aut | |
700 | 1 | |a Eidemüller, Markus |e verfasserin |4 aut | |
700 | 1 | |a Pazos, Montserrat |e verfasserin |4 aut | |
700 | 1 | |a Reitz, Daniel |e verfasserin |4 aut | |
700 | 1 | |a Rottler, Maya |e verfasserin |4 aut | |
700 | 1 | |a Freislederer, Philipp |e verfasserin |4 aut | |
700 | 1 | |a Braun, Michael |e verfasserin |4 aut | |
700 | 1 | |a Würstlein, Rachel |e verfasserin |4 aut | |
700 | 1 | |a Harbeck, Nadia |e verfasserin |4 aut | |
700 | 1 | |a Niyazi, Maximilian |e verfasserin |4 aut | |
700 | 1 | |a Belka, Claus |e verfasserin |4 aut | |
700 | 1 | |a Corradini, Stefanie |e verfasserin |4 aut | |
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10.1186/s13014-020-01520-8 doi (DE-627)SPR03981744X (SPR)s13014-020-01520-8-e DE-627 ger DE-627 rakwb eng 610 ASE Gaasch, Aurélie verfasserin aut Heart sparing radiotherapy in breast cancer: the importance of baseline cardiac risks 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Patients with left-sided breast cancer have an increased risk of cardiovascular disease (CVD) after radiotherapy (RT). While the awareness of cardiac toxicity has increased enormously over the last decade, the role of individual baseline cardiac risks has not yet been systematically investigated. Aim of the present study was to evaluate the impact of baseline CVD risks on radiation-induced cardiac toxicity. Methods Two hundred ten patients with left-sided breast cancer treated in the prospective Save-Heart Study using a deep inspiration breath-hold (DIBH) technique were analysed regarding baseline risk factors for CVD. Three frequently used prediction tools (Procam, Framingham and Reynolds score) were applied to evaluate the individual CVD risk profiles. Moreover, 10-year CVD excess absolute risks (EAR) were estimated using the individual mean heart dose (MHD) of treatment plans in free breathing (FB) and DIBH. Results The individual baseline CVD risk factors had a strong impact on the 10-year cumulative CVD risk. The mean baseline risks of the non-diabetic cohort (n = 200) ranged from 3.11 to 3.58%, depending on the risk estimation tool. A large number of the non-diabetic patients had a very low 10-year CVD baseline risk of ≤1%; nevertheless, 8–9% of patients reached ≥10% baseline 10-year CVD risk. In contrast, diabetic patients (n = 10) had significantly higher baseline CVD risks (range: 11.76–24.23%). The mean 10-year cumulative risk (Framingham score) following RT was 3.73% using the DIBH-technique (MHD:1.42Gy) and 3.94% in FB (MHD:2.33Gy), after adding a 10-year-EAR of + 0.34%(DIBH) and + 0.55%(FB) to the baseline risks, respectively. Smoking status was one of the most important and modifiable baseline risk factors. After DIBH-RT, the 182 non-smoking patients had a mean 10-year cumulative risk of 3.55% (3.20% baseline risk, 0.35% EAR) as compared to 6.07% (5.60% baseline risk, 0.47% EAR) for the 28 smokers. Conclusion In the present study, all CVD prediction tools showed comparable results and could easily be integrated into daily clinical practice. A systematic evaluation and screening helps to identify high-risk patients who may benefit from primary prevention. This could result in an even higher benefit than from heart-sparing irradiation techniques alone. Breast cancer (dpeaa)DE-He213 Breast conserving surgery (dpeaa)DE-He213 Radiotherapy (dpeaa)DE-He213 Heart sparing (dpeaa)DE-He213 Deep inspiration breath hold (DIBH) (dpeaa)DE-He213 Toxicity (dpeaa)DE-He213 Radiation-induced risk (dpeaa)DE-He213 Cardiovascular risk factors (dpeaa)DE-He213 Cardiac risk (dpeaa)DE-He213 Outcome (dpeaa)DE-He213 Schönecker, Stephan verfasserin aut Simonetto, Cristoforo verfasserin aut Eidemüller, Markus verfasserin aut Pazos, Montserrat verfasserin aut Reitz, Daniel verfasserin aut Rottler, Maya verfasserin aut Freislederer, Philipp verfasserin aut Braun, Michael verfasserin aut Würstlein, Rachel verfasserin aut Harbeck, Nadia verfasserin aut Niyazi, Maximilian verfasserin aut Belka, Claus verfasserin aut Corradini, Stefanie verfasserin aut Enthalten in Radiation oncology London : BioMed Central, 2006 15(2020), 1 vom: 24. Mai (DE-627)508725739 (DE-600)2224965-5 1748-717X nnns volume:15 year:2020 number:1 day:24 month:05 https://dx.doi.org/10.1186/s13014-020-01520-8 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2119 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 15 2020 1 24 05 |
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10.1186/s13014-020-01520-8 doi (DE-627)SPR03981744X (SPR)s13014-020-01520-8-e DE-627 ger DE-627 rakwb eng 610 ASE Gaasch, Aurélie verfasserin aut Heart sparing radiotherapy in breast cancer: the importance of baseline cardiac risks 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Patients with left-sided breast cancer have an increased risk of cardiovascular disease (CVD) after radiotherapy (RT). While the awareness of cardiac toxicity has increased enormously over the last decade, the role of individual baseline cardiac risks has not yet been systematically investigated. Aim of the present study was to evaluate the impact of baseline CVD risks on radiation-induced cardiac toxicity. Methods Two hundred ten patients with left-sided breast cancer treated in the prospective Save-Heart Study using a deep inspiration breath-hold (DIBH) technique were analysed regarding baseline risk factors for CVD. Three frequently used prediction tools (Procam, Framingham and Reynolds score) were applied to evaluate the individual CVD risk profiles. Moreover, 10-year CVD excess absolute risks (EAR) were estimated using the individual mean heart dose (MHD) of treatment plans in free breathing (FB) and DIBH. Results The individual baseline CVD risk factors had a strong impact on the 10-year cumulative CVD risk. The mean baseline risks of the non-diabetic cohort (n = 200) ranged from 3.11 to 3.58%, depending on the risk estimation tool. A large number of the non-diabetic patients had a very low 10-year CVD baseline risk of ≤1%; nevertheless, 8–9% of patients reached ≥10% baseline 10-year CVD risk. In contrast, diabetic patients (n = 10) had significantly higher baseline CVD risks (range: 11.76–24.23%). The mean 10-year cumulative risk (Framingham score) following RT was 3.73% using the DIBH-technique (MHD:1.42Gy) and 3.94% in FB (MHD:2.33Gy), after adding a 10-year-EAR of + 0.34%(DIBH) and + 0.55%(FB) to the baseline risks, respectively. Smoking status was one of the most important and modifiable baseline risk factors. After DIBH-RT, the 182 non-smoking patients had a mean 10-year cumulative risk of 3.55% (3.20% baseline risk, 0.35% EAR) as compared to 6.07% (5.60% baseline risk, 0.47% EAR) for the 28 smokers. Conclusion In the present study, all CVD prediction tools showed comparable results and could easily be integrated into daily clinical practice. A systematic evaluation and screening helps to identify high-risk patients who may benefit from primary prevention. This could result in an even higher benefit than from heart-sparing irradiation techniques alone. Breast cancer (dpeaa)DE-He213 Breast conserving surgery (dpeaa)DE-He213 Radiotherapy (dpeaa)DE-He213 Heart sparing (dpeaa)DE-He213 Deep inspiration breath hold (DIBH) (dpeaa)DE-He213 Toxicity (dpeaa)DE-He213 Radiation-induced risk (dpeaa)DE-He213 Cardiovascular risk factors (dpeaa)DE-He213 Cardiac risk (dpeaa)DE-He213 Outcome (dpeaa)DE-He213 Schönecker, Stephan verfasserin aut Simonetto, Cristoforo verfasserin aut Eidemüller, Markus verfasserin aut Pazos, Montserrat verfasserin aut Reitz, Daniel verfasserin aut Rottler, Maya verfasserin aut Freislederer, Philipp verfasserin aut Braun, Michael verfasserin aut Würstlein, Rachel verfasserin aut Harbeck, Nadia verfasserin aut Niyazi, Maximilian verfasserin aut Belka, Claus verfasserin aut Corradini, Stefanie verfasserin aut Enthalten in Radiation oncology London : BioMed Central, 2006 15(2020), 1 vom: 24. Mai (DE-627)508725739 (DE-600)2224965-5 1748-717X nnns volume:15 year:2020 number:1 day:24 month:05 https://dx.doi.org/10.1186/s13014-020-01520-8 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2119 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 15 2020 1 24 05 |
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10.1186/s13014-020-01520-8 doi (DE-627)SPR03981744X (SPR)s13014-020-01520-8-e DE-627 ger DE-627 rakwb eng 610 ASE Gaasch, Aurélie verfasserin aut Heart sparing radiotherapy in breast cancer: the importance of baseline cardiac risks 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Patients with left-sided breast cancer have an increased risk of cardiovascular disease (CVD) after radiotherapy (RT). While the awareness of cardiac toxicity has increased enormously over the last decade, the role of individual baseline cardiac risks has not yet been systematically investigated. Aim of the present study was to evaluate the impact of baseline CVD risks on radiation-induced cardiac toxicity. Methods Two hundred ten patients with left-sided breast cancer treated in the prospective Save-Heart Study using a deep inspiration breath-hold (DIBH) technique were analysed regarding baseline risk factors for CVD. Three frequently used prediction tools (Procam, Framingham and Reynolds score) were applied to evaluate the individual CVD risk profiles. Moreover, 10-year CVD excess absolute risks (EAR) were estimated using the individual mean heart dose (MHD) of treatment plans in free breathing (FB) and DIBH. Results The individual baseline CVD risk factors had a strong impact on the 10-year cumulative CVD risk. The mean baseline risks of the non-diabetic cohort (n = 200) ranged from 3.11 to 3.58%, depending on the risk estimation tool. A large number of the non-diabetic patients had a very low 10-year CVD baseline risk of ≤1%; nevertheless, 8–9% of patients reached ≥10% baseline 10-year CVD risk. In contrast, diabetic patients (n = 10) had significantly higher baseline CVD risks (range: 11.76–24.23%). The mean 10-year cumulative risk (Framingham score) following RT was 3.73% using the DIBH-technique (MHD:1.42Gy) and 3.94% in FB (MHD:2.33Gy), after adding a 10-year-EAR of + 0.34%(DIBH) and + 0.55%(FB) to the baseline risks, respectively. Smoking status was one of the most important and modifiable baseline risk factors. After DIBH-RT, the 182 non-smoking patients had a mean 10-year cumulative risk of 3.55% (3.20% baseline risk, 0.35% EAR) as compared to 6.07% (5.60% baseline risk, 0.47% EAR) for the 28 smokers. Conclusion In the present study, all CVD prediction tools showed comparable results and could easily be integrated into daily clinical practice. A systematic evaluation and screening helps to identify high-risk patients who may benefit from primary prevention. This could result in an even higher benefit than from heart-sparing irradiation techniques alone. Breast cancer (dpeaa)DE-He213 Breast conserving surgery (dpeaa)DE-He213 Radiotherapy (dpeaa)DE-He213 Heart sparing (dpeaa)DE-He213 Deep inspiration breath hold (DIBH) (dpeaa)DE-He213 Toxicity (dpeaa)DE-He213 Radiation-induced risk (dpeaa)DE-He213 Cardiovascular risk factors (dpeaa)DE-He213 Cardiac risk (dpeaa)DE-He213 Outcome (dpeaa)DE-He213 Schönecker, Stephan verfasserin aut Simonetto, Cristoforo verfasserin aut Eidemüller, Markus verfasserin aut Pazos, Montserrat verfasserin aut Reitz, Daniel verfasserin aut Rottler, Maya verfasserin aut Freislederer, Philipp verfasserin aut Braun, Michael verfasserin aut Würstlein, Rachel verfasserin aut Harbeck, Nadia verfasserin aut Niyazi, Maximilian verfasserin aut Belka, Claus verfasserin aut Corradini, Stefanie verfasserin aut Enthalten in Radiation oncology London : BioMed Central, 2006 15(2020), 1 vom: 24. Mai (DE-627)508725739 (DE-600)2224965-5 1748-717X nnns volume:15 year:2020 number:1 day:24 month:05 https://dx.doi.org/10.1186/s13014-020-01520-8 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2119 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 15 2020 1 24 05 |
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10.1186/s13014-020-01520-8 doi (DE-627)SPR03981744X (SPR)s13014-020-01520-8-e DE-627 ger DE-627 rakwb eng 610 ASE Gaasch, Aurélie verfasserin aut Heart sparing radiotherapy in breast cancer: the importance of baseline cardiac risks 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Patients with left-sided breast cancer have an increased risk of cardiovascular disease (CVD) after radiotherapy (RT). While the awareness of cardiac toxicity has increased enormously over the last decade, the role of individual baseline cardiac risks has not yet been systematically investigated. Aim of the present study was to evaluate the impact of baseline CVD risks on radiation-induced cardiac toxicity. Methods Two hundred ten patients with left-sided breast cancer treated in the prospective Save-Heart Study using a deep inspiration breath-hold (DIBH) technique were analysed regarding baseline risk factors for CVD. Three frequently used prediction tools (Procam, Framingham and Reynolds score) were applied to evaluate the individual CVD risk profiles. Moreover, 10-year CVD excess absolute risks (EAR) were estimated using the individual mean heart dose (MHD) of treatment plans in free breathing (FB) and DIBH. Results The individual baseline CVD risk factors had a strong impact on the 10-year cumulative CVD risk. The mean baseline risks of the non-diabetic cohort (n = 200) ranged from 3.11 to 3.58%, depending on the risk estimation tool. A large number of the non-diabetic patients had a very low 10-year CVD baseline risk of ≤1%; nevertheless, 8–9% of patients reached ≥10% baseline 10-year CVD risk. In contrast, diabetic patients (n = 10) had significantly higher baseline CVD risks (range: 11.76–24.23%). The mean 10-year cumulative risk (Framingham score) following RT was 3.73% using the DIBH-technique (MHD:1.42Gy) and 3.94% in FB (MHD:2.33Gy), after adding a 10-year-EAR of + 0.34%(DIBH) and + 0.55%(FB) to the baseline risks, respectively. Smoking status was one of the most important and modifiable baseline risk factors. After DIBH-RT, the 182 non-smoking patients had a mean 10-year cumulative risk of 3.55% (3.20% baseline risk, 0.35% EAR) as compared to 6.07% (5.60% baseline risk, 0.47% EAR) for the 28 smokers. Conclusion In the present study, all CVD prediction tools showed comparable results and could easily be integrated into daily clinical practice. A systematic evaluation and screening helps to identify high-risk patients who may benefit from primary prevention. This could result in an even higher benefit than from heart-sparing irradiation techniques alone. Breast cancer (dpeaa)DE-He213 Breast conserving surgery (dpeaa)DE-He213 Radiotherapy (dpeaa)DE-He213 Heart sparing (dpeaa)DE-He213 Deep inspiration breath hold (DIBH) (dpeaa)DE-He213 Toxicity (dpeaa)DE-He213 Radiation-induced risk (dpeaa)DE-He213 Cardiovascular risk factors (dpeaa)DE-He213 Cardiac risk (dpeaa)DE-He213 Outcome (dpeaa)DE-He213 Schönecker, Stephan verfasserin aut Simonetto, Cristoforo verfasserin aut Eidemüller, Markus verfasserin aut Pazos, Montserrat verfasserin aut Reitz, Daniel verfasserin aut Rottler, Maya verfasserin aut Freislederer, Philipp verfasserin aut Braun, Michael verfasserin aut Würstlein, Rachel verfasserin aut Harbeck, Nadia verfasserin aut Niyazi, Maximilian verfasserin aut Belka, Claus verfasserin aut Corradini, Stefanie verfasserin aut Enthalten in Radiation oncology London : BioMed Central, 2006 15(2020), 1 vom: 24. Mai (DE-627)508725739 (DE-600)2224965-5 1748-717X nnns volume:15 year:2020 number:1 day:24 month:05 https://dx.doi.org/10.1186/s13014-020-01520-8 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2119 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 15 2020 1 24 05 |
allfieldsSound |
10.1186/s13014-020-01520-8 doi (DE-627)SPR03981744X (SPR)s13014-020-01520-8-e DE-627 ger DE-627 rakwb eng 610 ASE Gaasch, Aurélie verfasserin aut Heart sparing radiotherapy in breast cancer: the importance of baseline cardiac risks 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Patients with left-sided breast cancer have an increased risk of cardiovascular disease (CVD) after radiotherapy (RT). While the awareness of cardiac toxicity has increased enormously over the last decade, the role of individual baseline cardiac risks has not yet been systematically investigated. Aim of the present study was to evaluate the impact of baseline CVD risks on radiation-induced cardiac toxicity. Methods Two hundred ten patients with left-sided breast cancer treated in the prospective Save-Heart Study using a deep inspiration breath-hold (DIBH) technique were analysed regarding baseline risk factors for CVD. Three frequently used prediction tools (Procam, Framingham and Reynolds score) were applied to evaluate the individual CVD risk profiles. Moreover, 10-year CVD excess absolute risks (EAR) were estimated using the individual mean heart dose (MHD) of treatment plans in free breathing (FB) and DIBH. Results The individual baseline CVD risk factors had a strong impact on the 10-year cumulative CVD risk. The mean baseline risks of the non-diabetic cohort (n = 200) ranged from 3.11 to 3.58%, depending on the risk estimation tool. A large number of the non-diabetic patients had a very low 10-year CVD baseline risk of ≤1%; nevertheless, 8–9% of patients reached ≥10% baseline 10-year CVD risk. In contrast, diabetic patients (n = 10) had significantly higher baseline CVD risks (range: 11.76–24.23%). The mean 10-year cumulative risk (Framingham score) following RT was 3.73% using the DIBH-technique (MHD:1.42Gy) and 3.94% in FB (MHD:2.33Gy), after adding a 10-year-EAR of + 0.34%(DIBH) and + 0.55%(FB) to the baseline risks, respectively. Smoking status was one of the most important and modifiable baseline risk factors. After DIBH-RT, the 182 non-smoking patients had a mean 10-year cumulative risk of 3.55% (3.20% baseline risk, 0.35% EAR) as compared to 6.07% (5.60% baseline risk, 0.47% EAR) for the 28 smokers. Conclusion In the present study, all CVD prediction tools showed comparable results and could easily be integrated into daily clinical practice. A systematic evaluation and screening helps to identify high-risk patients who may benefit from primary prevention. This could result in an even higher benefit than from heart-sparing irradiation techniques alone. Breast cancer (dpeaa)DE-He213 Breast conserving surgery (dpeaa)DE-He213 Radiotherapy (dpeaa)DE-He213 Heart sparing (dpeaa)DE-He213 Deep inspiration breath hold (DIBH) (dpeaa)DE-He213 Toxicity (dpeaa)DE-He213 Radiation-induced risk (dpeaa)DE-He213 Cardiovascular risk factors (dpeaa)DE-He213 Cardiac risk (dpeaa)DE-He213 Outcome (dpeaa)DE-He213 Schönecker, Stephan verfasserin aut Simonetto, Cristoforo verfasserin aut Eidemüller, Markus verfasserin aut Pazos, Montserrat verfasserin aut Reitz, Daniel verfasserin aut Rottler, Maya verfasserin aut Freislederer, Philipp verfasserin aut Braun, Michael verfasserin aut Würstlein, Rachel verfasserin aut Harbeck, Nadia verfasserin aut Niyazi, Maximilian verfasserin aut Belka, Claus verfasserin aut Corradini, Stefanie verfasserin aut Enthalten in Radiation oncology London : BioMed Central, 2006 15(2020), 1 vom: 24. Mai (DE-627)508725739 (DE-600)2224965-5 1748-717X nnns volume:15 year:2020 number:1 day:24 month:05 https://dx.doi.org/10.1186/s13014-020-01520-8 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2119 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 15 2020 1 24 05 |
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Enthalten in Radiation oncology 15(2020), 1 vom: 24. Mai volume:15 year:2020 number:1 day:24 month:05 |
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Enthalten in Radiation oncology 15(2020), 1 vom: 24. Mai volume:15 year:2020 number:1 day:24 month:05 |
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Breast cancer Breast conserving surgery Radiotherapy Heart sparing Deep inspiration breath hold (DIBH) Toxicity Radiation-induced risk Cardiovascular risk factors Cardiac risk Outcome |
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Gaasch, Aurélie @@aut@@ Schönecker, Stephan @@aut@@ Simonetto, Cristoforo @@aut@@ Eidemüller, Markus @@aut@@ Pazos, Montserrat @@aut@@ Reitz, Daniel @@aut@@ Rottler, Maya @@aut@@ Freislederer, Philipp @@aut@@ Braun, Michael @@aut@@ Würstlein, Rachel @@aut@@ Harbeck, Nadia @@aut@@ Niyazi, Maximilian @@aut@@ Belka, Claus @@aut@@ Corradini, Stefanie @@aut@@ |
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2020-05-24T00:00:00Z |
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While the awareness of cardiac toxicity has increased enormously over the last decade, the role of individual baseline cardiac risks has not yet been systematically investigated. Aim of the present study was to evaluate the impact of baseline CVD risks on radiation-induced cardiac toxicity. Methods Two hundred ten patients with left-sided breast cancer treated in the prospective Save-Heart Study using a deep inspiration breath-hold (DIBH) technique were analysed regarding baseline risk factors for CVD. Three frequently used prediction tools (Procam, Framingham and Reynolds score) were applied to evaluate the individual CVD risk profiles. Moreover, 10-year CVD excess absolute risks (EAR) were estimated using the individual mean heart dose (MHD) of treatment plans in free breathing (FB) and DIBH. Results The individual baseline CVD risk factors had a strong impact on the 10-year cumulative CVD risk. The mean baseline risks of the non-diabetic cohort (n = 200) ranged from 3.11 to 3.58%, depending on the risk estimation tool. A large number of the non-diabetic patients had a very low 10-year CVD baseline risk of ≤1%; nevertheless, 8–9% of patients reached ≥10% baseline 10-year CVD risk. In contrast, diabetic patients (n = 10) had significantly higher baseline CVD risks (range: 11.76–24.23%). The mean 10-year cumulative risk (Framingham score) following RT was 3.73% using the DIBH-technique (MHD:1.42Gy) and 3.94% in FB (MHD:2.33Gy), after adding a 10-year-EAR of + 0.34%(DIBH) and + 0.55%(FB) to the baseline risks, respectively. Smoking status was one of the most important and modifiable baseline risk factors. After DIBH-RT, the 182 non-smoking patients had a mean 10-year cumulative risk of 3.55% (3.20% baseline risk, 0.35% EAR) as compared to 6.07% (5.60% baseline risk, 0.47% EAR) for the 28 smokers. 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Gaasch, Aurélie |
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Gaasch, Aurélie ddc 610 misc Breast cancer misc Breast conserving surgery misc Radiotherapy misc Heart sparing misc Deep inspiration breath hold (DIBH) misc Toxicity misc Radiation-induced risk misc Cardiovascular risk factors misc Cardiac risk misc Outcome Heart sparing radiotherapy in breast cancer: the importance of baseline cardiac risks |
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610 ASE Heart sparing radiotherapy in breast cancer: the importance of baseline cardiac risks Breast cancer (dpeaa)DE-He213 Breast conserving surgery (dpeaa)DE-He213 Radiotherapy (dpeaa)DE-He213 Heart sparing (dpeaa)DE-He213 Deep inspiration breath hold (DIBH) (dpeaa)DE-He213 Toxicity (dpeaa)DE-He213 Radiation-induced risk (dpeaa)DE-He213 Cardiovascular risk factors (dpeaa)DE-He213 Cardiac risk (dpeaa)DE-He213 Outcome (dpeaa)DE-He213 |
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Gaasch, Aurélie Schönecker, Stephan Simonetto, Cristoforo Eidemüller, Markus Pazos, Montserrat Reitz, Daniel Rottler, Maya Freislederer, Philipp Braun, Michael Würstlein, Rachel Harbeck, Nadia Niyazi, Maximilian Belka, Claus Corradini, Stefanie |
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heart sparing radiotherapy in breast cancer: the importance of baseline cardiac risks |
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Heart sparing radiotherapy in breast cancer: the importance of baseline cardiac risks |
abstract |
Background Patients with left-sided breast cancer have an increased risk of cardiovascular disease (CVD) after radiotherapy (RT). While the awareness of cardiac toxicity has increased enormously over the last decade, the role of individual baseline cardiac risks has not yet been systematically investigated. Aim of the present study was to evaluate the impact of baseline CVD risks on radiation-induced cardiac toxicity. Methods Two hundred ten patients with left-sided breast cancer treated in the prospective Save-Heart Study using a deep inspiration breath-hold (DIBH) technique were analysed regarding baseline risk factors for CVD. Three frequently used prediction tools (Procam, Framingham and Reynolds score) were applied to evaluate the individual CVD risk profiles. Moreover, 10-year CVD excess absolute risks (EAR) were estimated using the individual mean heart dose (MHD) of treatment plans in free breathing (FB) and DIBH. Results The individual baseline CVD risk factors had a strong impact on the 10-year cumulative CVD risk. The mean baseline risks of the non-diabetic cohort (n = 200) ranged from 3.11 to 3.58%, depending on the risk estimation tool. A large number of the non-diabetic patients had a very low 10-year CVD baseline risk of ≤1%; nevertheless, 8–9% of patients reached ≥10% baseline 10-year CVD risk. In contrast, diabetic patients (n = 10) had significantly higher baseline CVD risks (range: 11.76–24.23%). The mean 10-year cumulative risk (Framingham score) following RT was 3.73% using the DIBH-technique (MHD:1.42Gy) and 3.94% in FB (MHD:2.33Gy), after adding a 10-year-EAR of + 0.34%(DIBH) and + 0.55%(FB) to the baseline risks, respectively. Smoking status was one of the most important and modifiable baseline risk factors. After DIBH-RT, the 182 non-smoking patients had a mean 10-year cumulative risk of 3.55% (3.20% baseline risk, 0.35% EAR) as compared to 6.07% (5.60% baseline risk, 0.47% EAR) for the 28 smokers. Conclusion In the present study, all CVD prediction tools showed comparable results and could easily be integrated into daily clinical practice. A systematic evaluation and screening helps to identify high-risk patients who may benefit from primary prevention. This could result in an even higher benefit than from heart-sparing irradiation techniques alone. |
abstractGer |
Background Patients with left-sided breast cancer have an increased risk of cardiovascular disease (CVD) after radiotherapy (RT). While the awareness of cardiac toxicity has increased enormously over the last decade, the role of individual baseline cardiac risks has not yet been systematically investigated. Aim of the present study was to evaluate the impact of baseline CVD risks on radiation-induced cardiac toxicity. Methods Two hundred ten patients with left-sided breast cancer treated in the prospective Save-Heart Study using a deep inspiration breath-hold (DIBH) technique were analysed regarding baseline risk factors for CVD. Three frequently used prediction tools (Procam, Framingham and Reynolds score) were applied to evaluate the individual CVD risk profiles. Moreover, 10-year CVD excess absolute risks (EAR) were estimated using the individual mean heart dose (MHD) of treatment plans in free breathing (FB) and DIBH. Results The individual baseline CVD risk factors had a strong impact on the 10-year cumulative CVD risk. The mean baseline risks of the non-diabetic cohort (n = 200) ranged from 3.11 to 3.58%, depending on the risk estimation tool. A large number of the non-diabetic patients had a very low 10-year CVD baseline risk of ≤1%; nevertheless, 8–9% of patients reached ≥10% baseline 10-year CVD risk. In contrast, diabetic patients (n = 10) had significantly higher baseline CVD risks (range: 11.76–24.23%). The mean 10-year cumulative risk (Framingham score) following RT was 3.73% using the DIBH-technique (MHD:1.42Gy) and 3.94% in FB (MHD:2.33Gy), after adding a 10-year-EAR of + 0.34%(DIBH) and + 0.55%(FB) to the baseline risks, respectively. Smoking status was one of the most important and modifiable baseline risk factors. After DIBH-RT, the 182 non-smoking patients had a mean 10-year cumulative risk of 3.55% (3.20% baseline risk, 0.35% EAR) as compared to 6.07% (5.60% baseline risk, 0.47% EAR) for the 28 smokers. Conclusion In the present study, all CVD prediction tools showed comparable results and could easily be integrated into daily clinical practice. A systematic evaluation and screening helps to identify high-risk patients who may benefit from primary prevention. This could result in an even higher benefit than from heart-sparing irradiation techniques alone. |
abstract_unstemmed |
Background Patients with left-sided breast cancer have an increased risk of cardiovascular disease (CVD) after radiotherapy (RT). While the awareness of cardiac toxicity has increased enormously over the last decade, the role of individual baseline cardiac risks has not yet been systematically investigated. Aim of the present study was to evaluate the impact of baseline CVD risks on radiation-induced cardiac toxicity. Methods Two hundred ten patients with left-sided breast cancer treated in the prospective Save-Heart Study using a deep inspiration breath-hold (DIBH) technique were analysed regarding baseline risk factors for CVD. Three frequently used prediction tools (Procam, Framingham and Reynolds score) were applied to evaluate the individual CVD risk profiles. Moreover, 10-year CVD excess absolute risks (EAR) were estimated using the individual mean heart dose (MHD) of treatment plans in free breathing (FB) and DIBH. Results The individual baseline CVD risk factors had a strong impact on the 10-year cumulative CVD risk. The mean baseline risks of the non-diabetic cohort (n = 200) ranged from 3.11 to 3.58%, depending on the risk estimation tool. A large number of the non-diabetic patients had a very low 10-year CVD baseline risk of ≤1%; nevertheless, 8–9% of patients reached ≥10% baseline 10-year CVD risk. In contrast, diabetic patients (n = 10) had significantly higher baseline CVD risks (range: 11.76–24.23%). The mean 10-year cumulative risk (Framingham score) following RT was 3.73% using the DIBH-technique (MHD:1.42Gy) and 3.94% in FB (MHD:2.33Gy), after adding a 10-year-EAR of + 0.34%(DIBH) and + 0.55%(FB) to the baseline risks, respectively. Smoking status was one of the most important and modifiable baseline risk factors. After DIBH-RT, the 182 non-smoking patients had a mean 10-year cumulative risk of 3.55% (3.20% baseline risk, 0.35% EAR) as compared to 6.07% (5.60% baseline risk, 0.47% EAR) for the 28 smokers. Conclusion In the present study, all CVD prediction tools showed comparable results and could easily be integrated into daily clinical practice. A systematic evaluation and screening helps to identify high-risk patients who may benefit from primary prevention. This could result in an even higher benefit than from heart-sparing irradiation techniques alone. |
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Heart sparing radiotherapy in breast cancer: the importance of baseline cardiac risks |
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Schönecker, Stephan Simonetto, Cristoforo Eidemüller, Markus Pazos, Montserrat Reitz, Daniel Rottler, Maya Freislederer, Philipp Braun, Michael Würstlein, Rachel Harbeck, Nadia Niyazi, Maximilian Belka, Claus Corradini, Stefanie |
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Schönecker, Stephan Simonetto, Cristoforo Eidemüller, Markus Pazos, Montserrat Reitz, Daniel Rottler, Maya Freislederer, Philipp Braun, Michael Würstlein, Rachel Harbeck, Nadia Niyazi, Maximilian Belka, Claus Corradini, Stefanie |
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While the awareness of cardiac toxicity has increased enormously over the last decade, the role of individual baseline cardiac risks has not yet been systematically investigated. Aim of the present study was to evaluate the impact of baseline CVD risks on radiation-induced cardiac toxicity. Methods Two hundred ten patients with left-sided breast cancer treated in the prospective Save-Heart Study using a deep inspiration breath-hold (DIBH) technique were analysed regarding baseline risk factors for CVD. Three frequently used prediction tools (Procam, Framingham and Reynolds score) were applied to evaluate the individual CVD risk profiles. Moreover, 10-year CVD excess absolute risks (EAR) were estimated using the individual mean heart dose (MHD) of treatment plans in free breathing (FB) and DIBH. Results The individual baseline CVD risk factors had a strong impact on the 10-year cumulative CVD risk. The mean baseline risks of the non-diabetic cohort (n = 200) ranged from 3.11 to 3.58%, depending on the risk estimation tool. A large number of the non-diabetic patients had a very low 10-year CVD baseline risk of ≤1%; nevertheless, 8–9% of patients reached ≥10% baseline 10-year CVD risk. In contrast, diabetic patients (n = 10) had significantly higher baseline CVD risks (range: 11.76–24.23%). The mean 10-year cumulative risk (Framingham score) following RT was 3.73% using the DIBH-technique (MHD:1.42Gy) and 3.94% in FB (MHD:2.33Gy), after adding a 10-year-EAR of + 0.34%(DIBH) and + 0.55%(FB) to the baseline risks, respectively. Smoking status was one of the most important and modifiable baseline risk factors. After DIBH-RT, the 182 non-smoking patients had a mean 10-year cumulative risk of 3.55% (3.20% baseline risk, 0.35% EAR) as compared to 6.07% (5.60% baseline risk, 0.47% EAR) for the 28 smokers. Conclusion In the present study, all CVD prediction tools showed comparable results and could easily be integrated into daily clinical practice. A systematic evaluation and screening helps to identify high-risk patients who may benefit from primary prevention. 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