Predicting acute coronary events after breast cancer radiotherapy: Integrating baseline cardiovascular risk, systemic therapy, and cardiac radiation dose in the MEDIRAD BRACE study

At ten years, the cumulative incidence of ACE was 4.8 % and 1.4 % in the development and external sets, respectively. Model 2, which included WH-D1, LV-V6, and right ventricle (RV)-V6, did not outperform Model 1 (LR p = 0.422). Consequently, further model improvement was pursued by expanding Model 1 rather than Model 2. The resulting Model 3 incorporated the parameters from Model 1 along with the total CAC volume, significantly enhancing predictive performance (LR p < 0.001). At 10 years post-RT, each model had c-indexes above 0.73 at internal validation, with Model 3 performing best (c-index 0.78; 95 % CI, 0.72-0.83) CONCLUSION: A model including seven clinical parameters, WH-Dmean, LV-V5, and total CAC volume best predicted ACE risk and may guide RT dose optimisation strategies.

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Publication Details

Journal
European Journal of Cancer
Published
2025-10-25
DOI
https://doi.org/10.1016/j.ejca.2025.116055
Citations
2
Primary Topic
Chemotherapy-induced cardiotoxicity and mitigation
Type
article
Field-Weighted Citation Impact
2.78
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article

Predicting acute coronary events after breast cancer radiotherapy: Integrating baseline cardiovascular risk, systemic therapy, and cardiac radiation dose in the MEDIRAD BRACE study

Johannes A. Langendijk, John H. Maduro, Pim van der Harst, N.M. Sijtsema et al.
2 citations
European Journal of Cancer
Chemotherapy-induced cardiotoxicity and mitigation
2.78
article

Predicting acute coronary events after breast cancer radiotherapy: Integrating baseline cardiovascular risk, systemic therapy, and cardiac radiation dose in the MEDIRAD BRACE study

Johannes A. Langendijk, John H. Maduro, Pim van der Harst, N.M. Sijtsema, Flora E. van Leeuwen, Naomi B. Boekel, G. Sikkema, Sophie Jacob, Anne P.G. Crijns, Stephanie Elisabeth Combs, N.S. Russell, E. Schuit, V.A.B. van den Bogaard, R. Vliegenthart, K. Borm, Michael Mayinger, Daan Spoor
article en
2 citations

Abstract

At ten years, the cumulative incidence of ACE was 4.8 % and 1.4 % in the development and external sets, respectively. Model 2, which included WH-D1, LV-V6, and right ventricle (RV)-V6, did not outperform Model 1 (LR p = 0.422). Consequently, further model improvement was pursued by expanding Model 1 rather than Model 2. The resulting Model 3 incorporated the parameters from Model 1 along with the total CAC volume, significantly enhancing predictive performance (LR p < 0.001). At 10 years post-RT, each model had c-indexes above 0.73 at internal validation, with Model 3 performing best (c-index 0.78; 95 % CI, 0.72-0.83) CONCLUSION: A model including seven clinical parameters, WH-Dmean, LV-V5, and total CAC volume best predicted ACE risk and may guide RT dose optimisation strategies.

European Journal of CancerVol. 231
University Medical Center Groningen (NL), University of Groningen (NL), Utrecht University (NL), TUM Klinikum (DE), The Netherlands Cancer Institute (NL), University Medical Center Utrecht (NL)
Openalex Percentile: Top 8%
Chemotherapy-induced cardiotoxicity and mitigation
2.78
DOIOpen Access PDFOpenAlex
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