Trial reportRadiation oncology (London, England)2020
Heart sparing radiotherapy in breast cancer: the importance of baseline cardiac risks.
Trial report in Radiation oncology (London, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed, 42 citations in OpenAlex.
- Consolidation ICIs Alter cardiac subregion radiosensitivity in NSCLC patients treated with Chemo-Radiotherapy.Clinical and translational radiation oncology · 2026Article
- Deep inspiration breath-hold for breast cancer radiotherapy: a modelling study of targeted versus non-targeted strategy for clinical and operational optimisation.The Lancet regional health. Europe · 2026Article
- Risk factors for early radiation-induced heart damage in patients undergoing pulmonary SBRT.Echo research and practice · 2025Article
- Radiation-induced heart disease in breast cancer patients: a narrative review of epidemiology, risk factors, radiotherapy parameters, and prevention.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2025Review
- Reduction of subclinical acute cardiac injury through DIBH radiotherapy: a single-institution real-world clinical cohort analysis.BMC cancer · 2025Article
- Coronary artery calcium and cardiovascular risk factors analysis after radiotherapy for breast cancer (the CLARIFIER: a gender-based preventive medicine study).Frontiers in cardiovascular medicine · 2025Article
- Surface-based deep inspiration breath-hold radiotherapy in left-sided breast cancer: final results from the SAVE-HEART study.ESMO open · 2024Article
- Research progress of cardiotoxicity caused by radiotherapy in breast cancer.Precision radiation oncology · 2024Review
- Organ-sparing techniques and dose-volume constrains used in breast cancer radiation therapy - Results from European and Latin American surveys.Clinical and translational radiation oncology · 2024Article
- Individual benefit in heart sparing during DIBH-supported left breast radiotherapy.Clinical and translational radiation oncology · 2024Article
- Dosimetric analysis of half-field-based VMAT with the deep inspiration breath-hold technique for left breast cancer patients following breast-conserving surgery.Frontiers in oncology · 2024Article
- Automated review of patient position in DIBH breast hybrid IMRT with EPID images.Journal of applied clinical medical physics · 2023Article
- Impact of breath-hold technique on incidence of cardiac events in adjuvant left breast cancer irradiation.Journal of cancer research and clinical oncology · 2023Article
- Current Cardioprotective Strategies for the Prevention of Radiation-Induced Cardiotoxicity in Left-Sided Breast Cancer Patients.Journal of personalized medicine · 2023Review
- Deep inspiration breath-hold radiation therapy in left-sided breast cancer patients: a single-institution retrospective dosimetric analysis of organs at risk doses.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2023Article
- Hazard-based risk grouping effectively stratifying breast cancer patients in post-irradiation long-term heart diseases: a population-based cohort study.Frontiers in cardiovascular medicine · 2023Article
- Radiation-Induced Cardiovascular Toxicities.Current treatment options in oncology · 2022Review
- Article
- Radiation-Induced Heart Disease.Journal of clinical medicine · 2021Review
- Immobilization-assisted abdominal deep inspiration breath-hold in post-mastectomy radiotherapy of left-sided breast cancer with internal mammary chain coverage.Quantitative imaging in medicine and surgery · 2021Article
Corrections and comments
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Authors and funding
14 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients 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.
methodsTwo 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.
resultsThe 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.
conclusionIn 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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