A Pilot Study of Cardiac MRI in Breast Cancer Survivors After Cardiotoxic Chemotherapy and Three-Dimensional Conformal Radiotherapy.
A Pilot Study of Cardiac MRI in Breast Cancer Survivors After Cardiotoxic Chemotherapy and Three-Dimensional Conformal Radiotherapy.
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DOI：
10.3389/fonc.2020.506739
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发表时间：
2020
影响因子：
4.7
通讯作者：
White J
中科院分区：
文献类型：
--
作者：
Bergom C;Rubenstein J;Wilson JF;Welsh A;Ibrahim EH;Prior P;Schottstaedt AM;Eastwood D;Zhang MJ;Currey A;Puckett L;Strande JL;Bradley JA;White J
淋巴结阳性的乳腺癌患者通常接受化疗和区域淋巴结照射。然而，这些治疗的心脏毒性作用可能会抵消一些生存益处。心脏磁共振（CMR）是一种新兴的方式来评估心脏损伤。这是一项在接受蒽环类药物化疗和三维适形放疗（3DCRT）区域淋巴结照射（使用心脏限制）的患者中使用CMR评估心脏损伤的初探性试验。入选2000-2008年接受蒽环类药物化疗和3DCRT区域淋巴结放疗（包括内乳链淋巴结）伴心室限制（V25 < 10%）的淋巴结阳性乳腺癌患者。分别对整个心脏（心包）以及心室和左心房（心肌）的组合进行心脏组织轮廓勾画和分析。CMR获得心室功能/尺寸、晚期钆增强（LGE）、整体纵向应变（GLS）和细胞外容积分数（ECV）作为心脏损伤和/或早期纤维化的指标。使用斯皮尔曼相关性将CMR参数与剂量-体积约束相关联。15例左侧和5例右侧患者接受了CMR。中位诊断年龄为50岁（32-77岁）。区域淋巴结照射前无基线心脏病患者。3DCRT后的中位时间为8.3年（5.2-14.4年）。左侧平均心脏剂量（MHD）中位数为4.8戈伊（1.1-11.2），V25为5.7%（0-12%）。中位左心室射血分数（LVEF）为63%。未观察到异常LGE。在全心脏剂量与LVEF、LV质量、GLS或LV尺寸之间未观察到相关性。增加ECV与增加心脏或心室剂量无关。然而，观察到较高的LV质量与心室平均剂量、V10和V25之间的相关性。在中位随访8.3年时，接受蒽环类药物化疗和区域淋巴结放疗的淋巴结阳性乳腺癌患者队列没有临床异常CMR结果。然而，心室平均剂量、V10和V25与LV质量之间存在相关性。更大的确证研究，包括先进的技术，测量区域心脏力学是必要的。
Node-positive breast cancer patients often receive chemotherapy and regional nodal irradiation. The cardiotoxic effects of these treatments, however, may offset some of the survival benefit. Cardiac magnetic resonance (CMR) is an emerging modality to assess cardiac injury. This is a pilot trial assessing cardiac damage using CMR in patients who received anthracycline-based chemotherapy and three-dimensional conformal radiotherapy (3DCRT) regional nodal irradiation using heart constraints. Node-positive breast cancer patients (2000–2008) treated with anthracycline-based chemotherapy and 3DCRT regional nodal irradiation (including the internal mammary chain nodes) with heart ventricular constraints (V25 < 10%) were invited to participate. Cardiac tissues were contoured and analyzed separately for whole heart (pericardium) and for combined ventricles and left atrium (myocardium). CMR obtained ventricular function/dimensions, late gadolinium enhancement (LGE), global longitudinal strain (GLS), and extracellular volume fraction (ECV) as measures of cardiac injury and/or early fibrosis. CMR parameters were correlated with dose-volume constraints using Spearman correlations. Fifteen left-sided and five right-sided patients underwent CMR. Median diagnosis age was 50 (32–77). No patients had baseline cardiac disease before regional nodal irradiation. Median time after 3DCRT was 8.3 years (5.2–14.4). Median left-sided mean heart dose (MHD) was 4.8 Gy (1.1–11.2) and V25 was 5.7% (0–12%). Median left ventricular ejection fraction (LVEF) was 63%. No abnormal LGE was observed. No correlations were seen between whole heart doses and LVEF, LV mass, GLS, or LV dimensions. Increasing ECV did not correlate with increased heart or ventricular doses. However, correlations between higher LV mass and ventricular mean dose, V10, and V25 were seen. At a median follow-up of 8.3 years, this cohort of node-positive breast cancer patients who received anthracycline-based chemotherapy and regional nodal irradiation had no clinically abnormal CMR findings. However, correlations between ventricular mean dose, V10, and V25 and LV mass were seen. Larger corroborating studies that include advanced techniques for measuring regional heart mechanics are warranted.
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影响因子：
158.5
作者：
Darby, Sarah C.;Ewertz, Marianne;Hall, Per
通讯作者：
Hall, Per
DOI：
10.1186/s12968-016-0308-4
发表时间：
2016-11-30
期刊：
Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance
影响因子：
--
作者：
Haaf P;Garg P;Messroghli DR;Broadbent DA;Greenwood JP;Plein S
通讯作者：
Plein S
影响因子：
51.1
作者：
Darby, SC;McGale, P;Peto, R
通讯作者：
Peto, R
DOI：
10.1016/j.ijrobp.2015.09.018
发表时间：
2016-05-01
影响因子：
7
作者：
Bradley, Julie A.;Dagan, Roi;Mendenhall, Nancy P.
通讯作者：
Mendenhall, Nancy P.
影响因子：
45.3
作者：
Gyenes, G;Gagliardi, G;Rutqvist, LE
通讯作者：
Rutqvist, LE