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Risk of Cardiac Disease in Patients With Breast Cancer: Impact of Patient-Specific Factors and Individual Heart Dose From Three-Dimensional Radiation Therapy Planning

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dc.contributor.author강석민-
dc.contributor.author금기창-
dc.contributor.author김경환-
dc.contributor.author김용배-
dc.contributor.author서창옥-
dc.contributor.author신재용-
dc.contributor.author오재원-
dc.contributor.author장지석-
dc.contributor.author전경현-
dc.contributor.author정승연-
dc.contributor.author강석민-
dc.contributor.author금기창-
dc.contributor.author김경환-
dc.contributor.author김용배-
dc.contributor.author서창옥-
dc.contributor.author신재용-
dc.contributor.author오재원-
dc.contributor.author장지석-
dc.contributor.author전경현-
dc.contributor.author정승연-
dc.date.accessioned2021-12-28T16:58:56Z-
dc.date.available2021-12-28T16:58:56Z-
dc.date.issued2021-06-
dc.identifier.issn0360-3016-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/186879-
dc.description.abstractPurpose: This retrospective cohort study aimed to determine whether adjuvant radiation therapy increases the risk of cardiac toxicity in Asian women with breast cancer, with a focus on patient-specific factors. Methods and materials: We evaluated women who underwent primary breast surgery for breast cancer with (n = 520) or without (n = 774) adjuvant radiation therapy between January 2005 and May 2013. Patients who underwent breast surgery without radiation therapy were categorized as patients who received 0 Gy to the heart. The primary endpoint was the occurrence of a breast cancer treatment-related heart disease (BCT-HD), defined as a diagnosis of angina pectoris, unstable angina, myocardial infarction, ischemic heart disease, heart failure, or atrial fibrillation. Results: In total, 1294 patients were included. The overall 5- and 10-year BCT-HD rates were 2.4% and 5.7%, respectively. The risk of an BCT-HD significantly increased per 1-Gy increase in the mean heart dose (adjusted hazard ratio: 1.23). Additionally, histories of hypertension (hazard ratio: 1.92), and diabetes (hazard ratio: 2.51) were found to be adverse risk factors, whereas regular physical exercise (hazard ratio: 0.17) was a protective factor. Subgroup analysis according to risk groups showed that the effect of increasing mean heart dose (per Gy) was similar between women without or with minimal risk factors (hazard ratio: 1.23) and women with multiple risk factors (hazard ratio: 1.27). Conclusions: The results indicate a radiation dose-effect relationship for cardiac disease in breast cancer patients, highlighting that there remains a considerable risk of cardiac toxicity even with 3-dimensional radiation therapy planning. Thus, measures to minimize the heart dose in breast cancer patients undergoing adjuvant radiation therapy, even in those without any risk factor for cardiac disease, should be routinely implemented.-
dc.description.statementOfResponsibilityrestriction-
dc.languageEnglish-
dc.publisherElsevier Science Inc.-
dc.relation.isPartOfINTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.subject.MESHAdult-
dc.subject.MESHAged-
dc.subject.MESHAged, 80 and over-
dc.subject.MESHAnthracyclines / therapeutic use-
dc.subject.MESHAsian Continental Ancestry Group-
dc.subject.MESHBreast Neoplasms / drug therapy-
dc.subject.MESHBreast Neoplasms / radiotherapy*-
dc.subject.MESHBreast Neoplasms / surgery-
dc.subject.MESHCardiotoxicity / etiology-
dc.subject.MESHDiabetes Mellitus-
dc.subject.MESHDose Fractionation, Radiation-
dc.subject.MESHDose-Response Relationship, Radiation-
dc.subject.MESHExercise-
dc.subject.MESHFemale-
dc.subject.MESHHeart / radiation effects*-
dc.subject.MESHHeart Diseases / etiology*-
dc.subject.MESHHumans-
dc.subject.MESHHypertension / complications-
dc.subject.MESHKaplan-Meier Estimate-
dc.subject.MESHMastectomy / methods-
dc.subject.MESHMiddle Aged-
dc.subject.MESHProportional Hazards Models-
dc.subject.MESHRadiation Dosage-
dc.subject.MESHRadiotherapy Planning, Computer-Assisted*-
dc.subject.MESHRadiotherapy, Adjuvant / adverse effects-
dc.subject.MESHRetrospective Studies-
dc.subject.MESHRisk-
dc.subject.MESHRisk Factors-
dc.subject.MESHYoung Adult-
dc.titleRisk of Cardiac Disease in Patients With Breast Cancer: Impact of Patient-Specific Factors and Individual Heart Dose From Three-Dimensional Radiation Therapy Planning-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Internal Medicine (내과학교실)-
dc.contributor.googleauthorSeung Yeun Chung-
dc.contributor.googleauthorJaewon Oh-
dc.contributor.googleauthorJee Suk Chang-
dc.contributor.googleauthorJaeyong Shin-
dc.contributor.googleauthorKyung Hwan Kim-
dc.contributor.googleauthorKyeong-Hyeon Chun-
dc.contributor.googleauthorKi Chang Keum-
dc.contributor.googleauthorChang-Ok Suh-
dc.contributor.googleauthorSeok-Min Kang-
dc.contributor.googleauthorYong Bae Kim-
dc.identifier.doi10.1016/j.ijrobp.2020.12.053-
dc.contributor.localIdA00037-
dc.contributor.localIdA00272-
dc.contributor.localIdA05226-
dc.contributor.localIdA00744-
dc.contributor.localIdA01919-
dc.contributor.localIdA02140-
dc.contributor.localIdA02395-
dc.contributor.localIdA04658-
dc.contributor.localIdA03500-
dc.contributor.localIdA05411-
dc.contributor.localIdA00037-
dc.contributor.localIdA00272-
dc.contributor.localIdA05226-
dc.contributor.localIdA00744-
dc.contributor.localIdA01919-
dc.contributor.localIdA02140-
dc.contributor.localIdA02395-
dc.contributor.localIdA04658-
dc.contributor.localIdA03500-
dc.contributor.localIdA05411-
dc.relation.journalcodeJ01157-
dc.identifier.eissn1879-355X-
dc.identifier.pmid33421556-
dc.identifier.urlhttps://www.redjournal.org/article/S0360-3016(21)00003-1/fulltext-
dc.contributor.alternativeNameKang, Seok Min-
dc.contributor.affiliatedAuthor강석민-
dc.contributor.affiliatedAuthor금기창-
dc.contributor.affiliatedAuthor김경환-
dc.contributor.affiliatedAuthor김용배-
dc.contributor.affiliatedAuthor서창옥-
dc.contributor.affiliatedAuthor신재용-
dc.contributor.affiliatedAuthor오재원-
dc.contributor.affiliatedAuthor장지석-
dc.contributor.affiliatedAuthor전경현-
dc.contributor.affiliatedAuthor정승연-
dc.contributor.affiliatedAuthor강석민-
dc.contributor.affiliatedAuthor금기창-
dc.contributor.affiliatedAuthor김경환-
dc.contributor.affiliatedAuthor김용배-
dc.contributor.affiliatedAuthor서창옥-
dc.contributor.affiliatedAuthor신재용-
dc.contributor.affiliatedAuthor오재원-
dc.contributor.affiliatedAuthor장지석-
dc.contributor.affiliatedAuthor전경현-
dc.contributor.affiliatedAuthor정승연-
dc.citation.volume110-
dc.citation.number2-
dc.citation.startPage473-
dc.citation.endPage481-
dc.identifier.bibliographicCitationINTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, Vol.110(2) : 473-481, 2021-06-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine (예방의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers

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