Evidence map›Paper›PMID 37511651›Full record

ReviewJournal of personalized medicine2023

Current Cardioprotective Strategies for the Prevention of Radiation-Induced Cardiotoxicity in Left-Sided Breast Cancer Patients.

Vasiliki Nikovia, Evangelos Chinis, Areti Gkantaifi, Maria Marketou, Michalis Mazonakis, Nikolaos Charalampakis, Dimitrios Mavroudis, Kornilia Vasiliki Orfanidou, Antonios Varveris, Chrysostomos Antoniadis and 1 more

Open access · goldAbstract readReview
In one paragraph

Review in Journal of personalized medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.3field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 6 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 1 country.

Vasiliki NikoviaMedical School, University of Crete, Vassilika, 71110 Heraklion, Greece.
Evangelos ChinisMedical School, University of Crete, Vassilika, 71110 Heraklion, Greece.
Areti GkantaifiRadiotherapy Department, Theagenio Anticancer Hospital of Thessaloniki, 54639 Thessaloniki, Greece.ORCID 0000-0001-7661-2087
Maria MarketouCardiology Department, University General Hospital of Heraklion, Heraklion, 71110 Heraklion, Greece.ORCID 0000-0003-1888-3430
Michalis MazonakisDepartment of Medical Physics, Faculty of Medicine, University of Cret, Iraklion, P.O. Box 2208, 71003 Heraklion, Greece.
Nikolaos CharalampakisOncology Clinic, Metaxa Cancer Hospital, Mpotasi 51, 18537 Piraeus, Greece.ORCID 0000-0002-8756-9659
Dimitrios MavroudisDepartment of Medical Oncology, University General Hospital of Heraklion, 71500 Heraklion, Greece.
Kornilia Vasiliki OrfanidouMedical School, University of Crete, Vassilika, 71110 Heraklion, Greece.
Antonios VarverisDepartment of Radiotherapy, University Hospital/Medical School, University of Crete, Vassilika, 71110 Heraklion, Greece.
Chrysostomos AntoniadisDepartment of Radiotherapy, University Hospital/Medical School, University of Crete, Vassilika, 71110 Heraklion, Greece.
Maria ToliaDepartment of Radiotherapy, University Hospital/Medical School, University of Crete, Vassilika, 71110 Heraklion, Greece.ORCID 0000-0002-3896-8426
University of Crete · GRUniversity Hospital of Heraklion · GRMetaxa Hospital · GRTheageneio General Hospital · GR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBreast cancer (BC) is the most common malignancy in females, accounting for the majority of cancer-related deaths worldwide. There is well-established understanding about the effective role of radiotherapy (RT) in BC therapeutic strategies, offering a better local-regional control, prolonged survival, and improved quality of life for patients. However, it has been proven that conventional RT modalities, especially in left-sided BC cases, are unable to avoid the administration of high RT doses to the heart, thus resulting in cardiotoxicity and promoting long-term cardiovascular diseases (CVD). Recent radiotherapeutic techniques, characterized by dosimetric dose restrictions, target volume revision/modifications, an increased awareness of risk factors, and consistent follow-ups, have created an advantageous context for a significant decrease inpost-RT CVD incidence.

aimThis review presents the fundamental role of current cardioprotective strategies in the prevention of cardiotoxic effects in left-BCRT. MATERIAL AND

methodsA literature search was conducted up to January 2023 using the Cochrane Central Register of Controlled Trials and PubMed Central databases. Our review refers to new radiotherapeutic techniques carried out on patients after BC surgery. Specifically, a dose evaluation of the heart and left anterior descending coronary artery (LADCA) was pointed out for all the included studies, depending on the implemented RT modality, bed positioning, and internal mammary lymph nodes radiation.

resultsSeveral studies reporting improved heart sparing with new RT techniques in BC patients were searched. In addition to the RT modality, which definitely determines the feasibility of achieving lower doses for the organs at risk (OARs), better target coverage, dose conformity and homogeneity, and the patient's position, characteristics, and anatomy may also affect the evaluated RT dose to the whole heart and its substructures.

conclusionsModern BC RT techniques seem to enable the administration of lower doses to the OARs without compromising on the target coverage. The analysis of several anatomical parameters and the assessment of cardiac biomarkers potentiate the protective effect of these new irradiation modalities, providing a holistic approach to the radiation-associated risks of cardiac disease for BC patients. Despite technological advances, an inevitable cardiac radiation risk still exists, while adverse cardiac events may be observed even many years after RT. Studies with longer follow-ups are required in order to determine the effectiveness of modern breast RT techniques.

Indexed as

cardioprotectionnewer radiotherapy methodsradiation-induced cardiotoxicity

Identifiers

PMID37511651
PMCPMC10381791
OpenAlexW4382062425

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.