Abstract 4044
Background
Radiotherapy halves the recurrence risk and reduces breast cancer death after breast sparing surgery, but it is associated cardiac morbidity and mortality (1). The EBCTCG data demonstrates an excess cardiac mortality rate ratio of 4,1% per increased Gray (Gy) whole heart dose (2). The aim of this study is to create a clinical applicable risk assessment model to predict 10-year cardiovascular mortality in female breast cancer patients.
Methods
By integration of the SCORE (Systematic COronary Risk Evaluation) risk charts and data of the EBCTCG we were able to develop cardiovascular mortality risk charts based on mean heart dose, age, systolic blood pressure, smoking-status and cholesterol for high- and low-risk regions in Europe, for contemporary mean heart doses of 2Gy, 4Gy and 8Gy.
Results
We will present tables showing the 10-year cardiovascular mortality based on mean heart dose, smoking status, age, systolic blood pressure and cholesterol for high- and low-risk regions in Europe. Below you find the risk table for 60-years old non-smoking women in low-risk regions. A 60-year old, non-smoking patient from France (low-risk region) with a cholesterol 220 mg/dl and a systolic blood pressure of 140 mmHg has a 10-year cardiovascular mortality risk of 1,0%, adding radiotherapy with a mean heart dose of 4Gy will increase it to 1,1% and doubling the heart dose to 8Gy results in a risk of 1,2%. In contrast, a 65 year old smoking patient living in Bosnia (high-risk region) with a cholesterol of 260 and a systolic blood pressure of 160 mmHg has a 10-year cardiovascular mortality risk of 13,0%, adding radiotherapy with a mean heart dose of 4Gy will increase it to 14,3% and doubling the heart dose to 8Gy results in a risk of 15,7%.Table:
189P
Cholesterol: 200-250 mg/ml Mean Heart Dose | Cholesterol: 250-300 mg/ml Mean Heart Dose | |||||||
---|---|---|---|---|---|---|---|---|
SBP | 0Gy | 2Gy | 4Gy | 8Gy | 0Gy | 2Gy | 4Gy | 8Gy |
180 mmHg | 3,0 | 3,2 | 3,3 | 3,6 | 4,0 | 4,2 | 4,4 | 4,9 |
160 mmHg | 2,0 | 2,1 | 2,2 | 2,4 | 2,0 | 2,1 | 2,2 | 2,4 |
140 mmHg | 1,0 | 1,1 | 1,1 | 1,2 | 2,0 | 2,1 | 2,2 | 2,4 |
120 mmHg | 1,0 | 1,1 | 1,1 | 1,2 | 1,0 | 1,1 | 1,1 | 1,2 |
Conclusions
Integrating cardiovascular risk tables and radiotherapy data are useful for patient individualized radiotherapy and cardiovascular prevention after breast cancer treatment. (1) Lancet 2011;378(9804):1707-16. (2) J Clin Oncol 2017;35(15):1641-1649.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Vrije Universiteit Brussel.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
3963 - Robot-assisted natural orifice specimen extraction surgery for radical resection of colorectal cancer
Presenter: Zhengchuan Niu
Session: Poster Display session 2
Resources:
Abstract
3989 - Bevacizumab as adjuvant treatment for colon cancer: Updated results from the AVANT phase III Study by the GERCOR Group
Presenter: Thierry André
Session: Poster Display session 2
Resources:
Abstract
4741 - Real world data on adjuvant chemotherapy for high-risk stage II colorectal cancer – the role of tumor side
Presenter: Camila Araujo de Carvalho
Session: Poster Display session 2
Resources:
Abstract
4973 - Oncological Outcome and Safety of Bevacizumab (BV) Therapy in Patients with Occlusive Colon Cancer and Self-Expandable Metal Stents (SEMS)
Presenter: Vilma Pacheco-Barcia
Session: Poster Display session 2
Resources:
Abstract
2295 - Active chronic hepatitis B increases the risk of liver metastasis of colorectal cancer- a retrospective clinical study of 7187 consecutive cases of newly diagnosed colorectal cancer
Presenter: Lei Zhao
Session: Poster Display session 2
Resources:
Abstract
3845 - Comprehensive Evaluation of Recurrence Risk (CERR) Score for Colorectal Liver Metastases: Development and Validation
Presenter: Wei Ye
Session: Poster Display session 2
Resources:
Abstract
1976 - BRAF-mutated colorectal metastases: what is the benefit of liver surgery? Results from a cohort of 91 patients.
Presenter: Sahir Javed
Session: Poster Display session 2
Resources:
Abstract
2688 - The smallest colorectal liver metastasis size as a prognosis factor after laparoscopic liver resection
Presenter: Baptiste Cervantes
Session: Poster Display session 2
Resources:
Abstract
4961 - Validation of GAME score risk groups in resected colorectal cancer liver metastases and the prognostic relevance of KRAS, NRAS and BRAF mutation analysis
Presenter: Berta Martin-Cullell
Session: Poster Display session 2
Resources:
Abstract
5295 - Predictive factors and survival outcomes with stereotactic body radiation therapy in treatment of oligometastases in colorectal cancer
Presenter: Vibhay Pareek
Session: Poster Display session 2
Resources:
Abstract