Meme kanseri nedeniyle radyoterapi uygulanan hastalarda Tp-e aralığı ve Tp-e/QT oranının prospektif olarak incelenmesi

Abstract

Amaç: Prospektif olarak dizayn edilen bu çalışmada amacımız sistemik kemoterapiyi takiben adjuvan radyoterapi (RT) ile tedavi edilen meme kanseri hastalarında Tp-e aralığı, Tp-e/QT oranı ve Tp-e/QTc oranını kullanarak ventriküler repolarizasyonu araştırmaktır. Metod: Çalışma ulusal, tek merkezli prospektif bir çalışma olarak tasarlandı. Tedavi protokolüne göre tüm hastalardan RT'nin ilk ve son günlerinde elektrokardiyogramlar (EKG) çekildi. EKG kayıtlarından Tp-e aralıkları, Tp-e/QT oranları ve Tp-e/QTc oranları hesaplandı. Radyasyon maruziyetine bağlı kalp dozları kalp mean doz, V5, V10,V20 ve V30 değerleri ile incelendi. Bulgular: Postoperatif sistemik tedavi sonrası adjuvan RT endikasyonu olan 51 hasta çalışmaya dahil edildi. Ortalama kalp dozu ortanca 205 cGy olarak gözlendi ve V30 değeri %0,01 idi. EKG ölçümleri incelendiğinde RT öncesine göre Tp-e aralığı (p<0,001), QT aralığı (p=0,007), Tp-e/QT oranı (p<0,001) ve Tp-e/QTc oranında (p<0,001) istatistiksel olarak anlamlı artışlar gözlendi. Ek olarak, ortalama kalp dozu ile RT sonrası Tp-e (r= 0.770,p<0.01) ve Tp-e/QTc oranı (r= 0.778,p<0.01) arasında pozitif korelasyonlar gözlendi. Sonuç: Ventriküler repolarizasyon süreci ve ventriküler ritim bozuklukları için prediktif olduğu düşünülen Tp-e intervali ve QT intervalinde RT öncesine göre istatistiksel olarak anlamlı uzama ve Tp-e/QT oranı ve Tp-e/QTc oranında artış saptandı. Ek olarak, ortalama kalp dozu ile Tp-e aralığı ve Tp-e/QTc oranı arasında pozitif korelasyon gözlendi.

Keywords

• Meme Kanseri
• Radyoterapi
• Tp-e Aralığı
• Kardiyak toksisite
• Tp-e/QT Oranı

Prospective examination of Tp-e interval and Tp-e/QT ratio in breast cancer patients receiving radiation therapy

Abstract

Aims: The aim of this prospective study was to investigate ventricular repolarization using the Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio in breast cancer patients treated with adjuvant radiotherapy(RT) following systemic chemotherapy. Methods: The study was designed as a national, single-center prospective study. According to the treatment protocol, electrocardiograms (ECGs) were taken from all patients on their first and last days of RT. Tp-e intervals, Tp-e/QT ratios, and Tp-e/QTc ratios were calculated based on the ECG recordings. The heart doses due to radiation exposure were examined with mean heart dose, V5, V10,V20, and V30 values. Results: 51 postsurgical patients, who were all treated with AC followed by weekly paclitaxel and had an indication for adjuvant RT, were included in the study. The mean heart dose was observed as median 205 cGy, and the V30 value was 0.01%. When ECG measurements were analyzed, statistically significant increases were observed in Tp-e interval (p<0.001), QT interval (p=0.007), Tp-e/QT ratio (p<0.001), and Tp-e/QTc ratio (p<0.001) at the end of RT. Additionally, positive correlations were observed between mean heart dose and post RT Tp-e (r= 0.770,p<0.01) and Tp-e/QTc ratio (r = 0.778,p<0.01) Conclusion: When compared to before RT, statistically significant prolongation of Tp-e interval and QT interval and increases in Tp-e/QT ratio and Tp-e/QTc ratio were detected which are thought to be predictive for ventricular repolarization process and ventricular rhythm disorders. In addition, the mean heart dose was positively correlated with Tp-e interval and Tp-e/QTc ratio.

Keywords

• Radiotherapy
• cardiac toxicity
• breast cancer
• Tp-e interval
• Tp-e/QT ratio
• Tp-e/QTc ratio

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