ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2017
Validation and Modification of a Prediction Model for Acute Cardiac Events in Patients With Breast Cancer Treated With Radiotherapy Based on Three-Dimensional Dose Distributions to Cardiac Substructures.
Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 254 papers, 1 of them a synthesis that pooled it.
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Who cites it
254 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Surface-guided deep-inspiration breath-hold radiotherapy for left-sided breast cancer: a systematic review and meta-analysis of dosimetric outcomes and image-verified setup accuracy.Frontiers in oncology · 2026Pooled it
- Trial
- Ultra-Hypofractionated vs. Moderate Fractionated Whole Breast Three Dimensional Conformal Radiotherapy during the COVID-19 Pandemic.Medicina (Kaunas, Lithuania) · 2022Trial
- A clinical trial to compare a 3D-printed bolus with a conventional bolus with the aim of reducing cardiopulmonary exposure in postmastectomy patients with volumetric modulated arc therapy.Cancer medicine · 2022Trial
- Deep-inspirational breath-hold (DIBH) technique in left-sided breast cancer: various aspects of clinical utility.Radiation oncology (London, England) · 2021Trial
- Adjuvant breast inversely planned intensity-modulated radiotherapy with simultaneous integrated boost for early stage breast cancer : Results from a phase II trial.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2020Trial
- The impact of effective dose to the immune cells on survival in breast cancer patients.Clinical and translational radiation oncology · 2026Article
- Longitudinal changes in NT-proBNP after breast cancer radiotherapy: clinical determinants of its trajectory and association with cardiac dysfunction (BACCARAT study).Clinical and translational radiation oncology · 2026Article
- A neighborhood attention transformer network for enhanced 3D segmentation of the left anterior descending artery.Medical physics · 2026Article
- Laterality of Breast Radiotherapy and Ischemic Heart Disease by Cardiovascular Risk Burden.JAMA network open · 2026Article
- Feasibility and trade-offs of incorporating cardiac substructure dose constraints in left-sided breast volumetric modulated arc therapy planning.Radiation oncology journal · 2026Article
- Article
- Optimizing Cardiac Dose Prediction in Left-Sided Breast Cancer Radiation Therapy: Clinical Strategies for Identifying Beneficiaries of the Deep Inspiration Breath-Hold Technique.Advances in radiation oncology · 2026Article
- Cardiac substructure dosimetry in thoracic radiotherapy: moving beyond mean heart dose and toward precision cardiac risk mitigation.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2026Review
- Heart Substructure Radiation Dose and Cardiac Outcomes: Contemporary Evidence and Actionable Opportunities: JACC CardioOncology State-of-the-Art Review.JACC. CardioOncology · 2026Review
- Impact of Radiation Therapy on Diastolic Function and Cardiac Troponin I Levels in Cancer Patients Undergoing Contemporary Radiotherapy.Circulation reports · 2026Article
- The Impact of Adjuvant Radiotherapy Combined With Targeted or Immunotherapy on the Heart in Breast Cancer.Thoracic cancer · 2026Review
- A new model of heart failure with preserved ejection fraction using external radiation therapy in male rats.Physiological reports · 2026Article
- Radiation Doses to Cardiac Substructures Predict Elevation in High-sensitivity Cardiac Troponin T Levels in Radiation Therapy for Lung Cancer.International journal of radiation oncology, biology, physics · 2026Article
- Treatment planning comparison of proton arc therapy and intensity modulated proton therapy for synchronous bilateral breast or chest wall and regional nodal irradiation.Physics and imaging in radiation oncology · 2026Article
194 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
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- Erratum issuedErrata.2017
Authors and funding
15 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Purpose A relationship between mean heart dose (MHD) and acute coronary event (ACE) rate was reported in a study of patients with breast cancer (BC). The main objective of our cohort study was to validate this relationship and investigate if other dose-distribution parameters are better predictors for ACEs than MHD. Patients and Methods The cohort consisted of 910 consecutive female patients with BC treated with radiotherapy (RT) after breast-conserving surgery. The primary end point was cumulative incidence of ACEs within 9 years of follow-up. Both MHD and various dose-distribution parameters of the cardiac substructures were collected from three-dimensional computed tomography planning data. Results The median MHD was 2.37 Gy (range, 0.51 to 15.25 Gy). The median follow-up time was 7.6 years (range, 0.1 to 10.1 years), during which 30 patients experienced an ACE. The cumulative incidence of ACE increased by 16.5% per Gy (95% CI, 0.6 to 35.0; P = .042). Analysis showed that the volume of the left ventricle receiving 5 Gy (LV-V5) was the most important prognostic dose-volume parameter. The most optimal multivariable normal tissue complication probability model for ACEs consisted of LV-V5, age, and weighted ACE risk score per patient (c-statistic, 0.83; 95% CI, 0.75 to 0.91). Conclusion A significant dose-effect relationship was found for ACEs within 9 years after RT. Using MHD, the relative increase per Gy was similar to that reported in the previous study. In addition, LV-V5 seemed to be a better predictor for ACEs than MHD. This study confirms the importance of reducing exposure of the heart to radiation to avoid excess risk of ACEs after radiotherapy for BC.
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