NYMC Faculty Publications

Long-Term Cardiovascular Mortality After Radiotherapy for Breast Cancer: A Systematic Review and Meta-Analysis

DOI

10.1002/clc.22631

Journal Title

Clinical Cardiology

First Page

73

Last Page

81

Document Type

Article

Publication Date

2-1-2017

Department

Medicine

Keywords

Breast Cancer; Cardiovascular Mortality; Radiotherapy, meta-analysis, cardiovascular disease etiology, radiation dose-response relationship, global health, incidence, radiation injuries epidemiology, adjuvant radiotherapy adverse effects, risk factors, survival rate trends

Disciplines

Cardiology | Medicine and Health Sciences | Neoplasms | Therapeutics

Abstract

BACKGROUND: Radiotherapy (RT) is frequently associated with late cardiovascular (CV) complications. The mean cardiac dose from irradiation of a left-sided breast cancer is much higher than that for a right-sided breast cancer. However, data is limited on the long-term risks of RT on CV mortality. HYPOTHESIS: RT for breast cancer is associated with long term CV mortality and left sided RT carries a greater mortality than right sided RT. METHODS: We searched PubMed, Cochrane Central, Embase, EBSCO, Web of Science, and CINAHL databases from inception through December 2015. Studies reporting CV mortality with RT for left- vs right-sided breast cancers were included. The principal outcome of interest was CV mortality. We calculated summary risk ratio (RR) and 95% confidence intervals (CI) with the random-effects model. RESULTS: The analysis included 289 109 patients from 13 observational studies. Women who had received RT for left-sided breast cancer had a higher risk of CV death than those who received RT for a right-sided breast cancer (RR: 1.12, 95% CI: 1.07-1.18, P /=15 years of follow-up.

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