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Cardiac markers in left-sided breast cancer patients receiving adjuvant radiotherapy: a prospective study

Chufal, Kundan; Ahmad, Irfan; Prakash, Anuj; Miller, Alexis; Umesh, Preetha; Koul, Varsha; Bajpai, Ram; Dua, Bharat; Gupta, Priya; Gairola, Munish

Authors

Kundan Chufal

Irfan Ahmad

Anuj Prakash

Alexis Miller

Preetha Umesh

Varsha Koul

Bharat Dua

Priya Gupta

Munish Gairola



Abstract

Objectives
To investigate the association between radiotherapy (RT) and cardiac biomarkers in women with left-sided breast cancer.

Methods
This prospective observational study recruited patients with stage I-III left-sided breast cancer without coronary heart disease who required adjuvant RT. High-sensitivity troponin I(hsTnI), N-terminal pro-brain natriuretic peptide(NT-proBNP), and high-sensitivity C-reactive protein(hsCRP) levels were measured pre-RT, immediately after RT, and 3 months post-RT. Cardiac-sparing RT techniques were utilized (Field-in-Field IMRT/VMAT ± voluntary deep inspiration breath-hold). Statistical analyses were performed using non-parametric tests and multivariable quantile regression (QR).

Results
One hundred five patients completed the study, with 63 evaluable at three months post-RT. Pre- and post-RT biomarkers showed no significant differences. Median pre-RT and post-RT values were: hsTnI (0.012ng/mL; 0.012ng/mL), hsCRP (3.1 mg/L; 2.8 mg/L), and NT-proBNP (59pg/mL; 45pg/mL). Three months post-RT, hsTnI, hsCRP and NT-proBNP levels also showed no significant differences. Multivariable QR revealed no association between heart Dmean [median(IQR): 2.87 Gy (2.05–3.94)] and post-RT biomarkers. Age and BMI were associated with hsCRP and NT-proBNP, respectively.

Conclusions
hsTnI, NT-proBNP, and hsCRP are not correlated with contemporary low cardiac exposure in left-sided breast cancer patients treated with contemporary RT techniques.

Citation

Chufal, K., Ahmad, I., Prakash, A., Miller, A., Umesh, P., Koul, V., …Gairola, M. (in press). Cardiac markers in left-sided breast cancer patients receiving adjuvant radiotherapy: a prospective study. Cardio-Oncology, 10(1), Article 21. https://doi.org/10.1186/s40959-024-00225-1

Journal Article Type Article
Acceptance Date Mar 25, 2024
Online Publication Date Apr 8, 2024
Deposit Date Apr 15, 2024
Publicly Available Date Apr 15, 2024
Journal Cardio-Oncology
Electronic ISSN 2057-3804
Publisher Springer Nature [academic journals on nature.com]
Peer Reviewed Peer Reviewed
Volume 10
Issue 1
Article Number 21
DOI https://doi.org/10.1186/s40959-024-00225-1
Keywords Breast cancer, Hypofractionated Radiotherapy, NT-proBNP, hsTnI, hsCRP
Public URL https://keele-repository.worktribe.com/output/793937
Publisher URL https://cardiooncologyjournal.biomedcentral.com/articles/10.1186/s40959-024-00225-1

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Licence
https://creativecommons.org/licenses/by/4.0/

Publisher Licence URL
https://creativecommons.org/licenses/by/4.0/

Copyright Statement
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.






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