A Higher Mean Heart Radiation Dose Induces Higher Frequency of Multiple Cardiac Changes

Suvi Sirkku Tuohinen, Hanna Aula, Tanja Skyttä, Heini Huhtala, Konsta Keski-Pukkila, Kjell Nikus, Vesa Virtanen, Pirkko Liisa Kellokumpu-Lehtinen, Pekka Raatikainen

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BACKGROUND/AIM: Radiotherapy (RT) induces late changes in all cardiac structures. Most studies of early changes focus on individual parameters. PATIENTS AND METHODS: Data from eighty early-stage breast cancer patients at baseline, post-RT and three-year follow-up visit were assessed prospectively. Changes in ten cardiac parameters were collected including electrocardiogram (ECG), echocardiography, and biomarkers. A percentage of abnormal changes was calculated. RESULTS: The mean heart radiation dose (Dmean) was independently associated with the increased incidence of changes post-RT (β=0.403, p<0.001) and at the three-year follow-up (β=0.353, p=0.001). Each 1-Gray increase in Dmean increased the cardiac changes by 3.7% (95%CI=1.9-5.6%) after RT and 3.1% (95%CI=1.3, 4.9%) at the three-year follow-up. CONCLUSION: A higher cardiac radiation dose was independently associated with a higher incidence of changes in cardiac parameters. Multiparameter changes imply that the early phase after RT is already characterized by several overlapping cardiac changes.

Original languageEnglish
Pages (from-to)2519-2529
Number of pages11
JournalAnticancer research
Issue number5
Publication statusPublished - May 2022
Publication typeA1 Journal article-refereed


  • Breast cancer
  • cardiac biomarkers
  • ECG
  • echocardiography
  • radiotherapy

Publication forum classification

  • Publication forum level 1

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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