The Impact of Tumor Location on Cardiac Toxicity in Patients Receiving Partial Breast Irradiation

Document Type

Conference Proceeding

Publication Date

10-2023

Publication Title

International Journal of Radiation Oncology, Biology, Physics

Abstract

Purpose/Objective(s): Accelerated partial breast irradiation (APBI) is an appropriate modality for select women with low-risk breast cancer. While APBI delivers radiation dose to a smaller volume of breast tissue compared to whole breast irradiation, dose to the heart and coronary vessels may be relatively high, depending on the proximity of the tumor bed to these structures. The purpose of this study is to determine if there is a correlation between tumor location and risk of adverse cardiac events in women receiving APBI. Materials/Methods: This retrospective study included 341 women who received ABPI from 1993 to February 2017 at a single institution. APBI was delivered by catheter-based high-dose-rate (HDR) brachytherapy via single lumen or multi-channel devices (n = 340), or external beam brachytherapy (n = 1). Neither the heart nor cardiac substructures were contoured for patients receiving APBI with HDR brachytherapy. Univariate analysis (UVA) and multivariable analysis (MVA) were conducted to correlate patient age, smoking status, Charlson Comorbidity Index score (CCI), receipt of systemic therapy, and tumor location (right outer, right inner/ central, left outer, left inner/central) with subsequent cardiac events. Results: Univariate analyses for patient age, smoking status, CCI, receipt of systemic therapy, and tumor location in correlation to subsequent cardiac events were performed. On UVA, age at diagnosis and CCI score ≥2 were both significant with HR of 1.07 [1.05-1.10] (p

Volume

117

Issue

2 Suppl.

First Page

e178

Last Page

e179

Comments

American Society for Radiation Oncology 65th Annual Meeting ASTRO 2023, October 1-4, 2023, San Diego, CA

DOI

10.1016/j.ijrobp.2023.06.1028

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