Radiation to supraclavicular and internal mammary lymph nodes in breast cancer increases the risk of stroke.
Radiation to supraclavicular and internal mammary lymph nodes in breast cancer increases the risk of stroke.
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DOI：
10.1038/sj.bjc.6604902
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发表时间：
2009-03-10
影响因子：
8.8
通讯作者：
Blomqvist, C.
中科院分区：
文献类型：
--
作者：
Nilsson, G.;Holmberg, L.;Garmo, H.;Terent, A.;Blomqvist, C.
本研究的目的是评估乳腺癌（BC）的辅助治疗是否会影响中风风险，并探讨与中风风险和部位相关的放射目标和分次剂量。在 1970 年至 2003 年期间诊断的瑞典 BC 队列中，我们对 BC 后卒中进行了巢式病例对照研究，并从病历中提取了相关详细信息。放疗 (RT) 与未放疗的比值比 (OR) 在病例和对照之间没有差异（OR=0.85；置信区间，CI=0.6–1.3）。与不进行放疗相比，对内乳链 (IMC) 和锁骨上 (SCL) 淋巴结进行放疗与较高的中风风险相关，尽管没有统计学意义（OR=1.3；CI=0.8-2.2）。在一项汇总分析中，与未进行 IMC 和 SCL 放疗以及未进行乳房/胸壁/腋窝放疗（但不包括 IMC 和 SCL）的合并组相比，中风发生率显着增加（OR=1.8；CI=1.1-2.8）。癌症偏侧性、放疗目标和中风部位之间没有关联。放射目标 IMC 和 SCL 显示出每日分次剂量中风风险增加的统计显着趋势。我们发现特定目标的中风风险增加以及每日分次剂量的剂量反应关系表明，IMC 和 SCL 的 RT 与中风风险之间可能存在因果关系。
The aim of this study was to assess whether adjuvant treatment of breast cancer (BC) affects the risk of stroke, and to explore radiation targets and fraction doses regarding risk and location of stroke. In a Swedish BC cohort diagnosed during 1970–2003, we carried out a nested case–control study of stroke after BC, with relevant details extracted from medical records. The odds ratio (OR) for radiotherapy (RT) vs that of no RT did not differ between cases and controls (OR=0.85; confidence interval, CI=0.6–1.3). Radiotherapy to internal mammary chain (IMC) and supraclavicular (SCL) lymph nodes vs that of no RT was associated with a higher, although not statistically significant, risk of stroke (OR=1.3; CI=0.8–2.2). In a pooled analysis, RT to IMC and SCL vs the pooled group of no RT and RT to breast/chest wall/axilla (but not IMC and SCL), showed a significant increase of stroke (OR=1.8; CI=1.1–2.8). There were no associations between cancer laterality, targets of RT, and location of stroke. The radiation targets, IMC and SCL, showed a statistically significant trend for an increased risk of stroke with daily fraction dose. Our finding of a target-specific increased risk of stroke and a dose-response relationship for daily fraction dose, indicate that there may be a causal link between RT to the IMC and SCL and risk of stroke.
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影响因子：
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