Cardiovascular Morbidity After Radiotherapy or Chemoradiation in Patients With Cervical Cancer

Journal Article · Wed Dec 01 00:00:00 EST 2010 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2009.09.061· OSTI ID:21491498

Maduro, John H ^[1]; Dekker, Helena A. den; Pras, Elisabeth ^[1]; Vries, Elisabeth G. de ^[2]; Zee, Ate G. van der ^[3]; Klokman, Willem J ^[4]; Reyners, Anna K ^[2]; Leeuwen, Flora E. van ^[4]; Langendijk, Johannes A ^[1]; Bock, Geertruida H. de ^[5]

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1. Department of Radiation Oncology, University of Groningen and University Medical Center Groningen, Groningen (Netherlands)
2. Department of Medical Oncology, University of Groningen and University Medical Center Groningen, Groningen (Netherlands)
3. Department of Gynecologic Oncology, University of Groningen and University Medical Center Groningen, Groningen (Netherlands)
4. Department of Epidemiology, the Netherlands Cancer Institute, Amsterdam (Netherlands)
5. Department of Epidemiology, University of Groningen and University Medical Center Groningen, Groningen (Netherlands)

Purpose: To evaluate the risk of cardiovascular events (CVE) in patients with cervical cancer treated with radiotherapy or chemoradiation. Methods and Materials: The incidence of CVE in patients treated between 1989 and 2002 by radiotherapy or chemoradiation was compared with a Dutch reference population. Standardized incidence ratios (SIRs) were calculated for myocardial infarction (MI), angina pectoris (AP), congestive heart failure (CHF), cerebrovascular accident (CVA) separately and for any cardiac event combined (MI, AP, and CHF). Results: In 277 patients with a median follow-up of 4.5 years (range, 0.1-17 years) and a median survival of 9.2 years, 27 cardiac events occurred. The 5-, 10-, and 15-year actuarial incidence of any cardiac event were 9, 14, and 16%, respectively. For the whole population, the SIR for MI was elevated (2.05, 95% CI: 1.12-3.43). The radiotherapy group (n = 132) was older and had more cardiovascular risk factors than the chemoradiation group (n = 145). The SIR for MI in the radiotherapy group was 2.88 (95% CI: 1.44-5.15) and in the chemoradiation group 1.00 (95% CI: 0.21-7.47). In multivariate analyses, there was no relation between treatment modality and the risk for MI. Conclusions: In this cohort of cervical cancer patients, an increased risk for developing a MI was observed. This increased risk of MI, in combination with the high prevalence of cardiovascular risk factors in cervical cancer patients, urges the need to explore strategies to reduce their risk for cardiovascular morbidity.

• OSTI ID: 21491498
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 78, Issue 5; Other Information: DOI: 10.1016/j.ijrobp.2009.09.061; PII: S0360-3016(09)03396-3; Copyright (c) 2010 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARCINOMAS
CHEMOTHERAPY
DISEASE INCIDENCE
HEART FAILURE
MULTIVARIATE ANALYSIS
MYOCARDIAL INFARCTION
RADIATION HAZARDS
RADIOTHERAPY
UROGENITAL SYSTEM DISEASES
CARDIOVASCULAR DISEASES
DISEASES
HAZARDS
HEALTH HAZARDS
MATHEMATICS
MEDICINE
NEOPLASMS
NUCLEAR MEDICINE
RADIOLOGY
STATISTICS
SYMPTOMS
THERAPY