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Open Access 01-12-2016 | Study protocol

Early detection and prediction of cardiotoxicity after radiation therapy for breast cancer: the BACCARAT prospective cohort study

Authors: Sophie Jacob, Atul Pathak, Denis Franck, Igor Latorzeff, Gaelle Jimenez, Olivier Fondard, Matthieu Lapeyre, Daniel Colombier, Eric Bruguiere, Olivier Lairez, Benoit Fontenel, Fabien Milliat, Radia Tamarat, David Broggio, Sylvie Derreumaux, Marianne Ducassou, Jean Ferrières, Dominique Laurier, Marc Benderitter, Marie-Odile Bernier

Published in: Radiation Oncology | Issue 1/2016

Abstract

Background

Radiotherapy (RT) for breast cancer presents a benefit in terms of reducing local recurrence and deaths resulting from breast cancer but it can lead to secondary effects due to the presence of neighboring cardiac normal tissues within the irradiation field. Breast RT has been shown to be associated with long-term increased risk of heart failure, coronary artery disease, myocardial infarction and finally cardiovascular death more than 10 years after RT. However, there is still a lack of knowledge for early cardiotoxicity induced by breast RT that can appear long before the onset of clinically significant cardiac events. Based on a 2-year follow-up prospective cohort of patients treated with breast RT, the BACCARAT (BreAst Cancer and CArdiotoxicity Induced by RAdioTherapy) study aims to enhance knowledge on detection and prediction of early subclinical cardiac dysfunction and lesions induced by breast RT and on biological mechanisms potentially involved, based on functional and anatomical cardiac imaging combined with simultaneous assessment of multiple circulating biomarkers and accurate heart dosimetry.

Methods/Design

BACCARAT study consists in a monocentric prospective cohort study that will finally include 120 women treated with adjuvant 3D CRT for breast cancer, and followed for 2 years after RT. Women aged 50 to 70 years, treated for breast cancer and for whom adjuvant 3D CRT is indicated, without chemotherapy are eligible for the study. Baseline (before RT) and follow-up data include measurements of functional myocardial dysfunction including strain and strain rate based on 2D-speckle tracking echocardiography, anatomical coronary lesions including description of plaques in segments of coronary arteries based on Coronary computed tomography angiography, and a wide panel of circulating biomarkers. The absorbed dose is evaluated for the whole heart and its substructures, in particular the coronary arteries. Analysis on occurrence and evolution of subclinical cardiac lesions and biomarkers will be performed and completed with dose-response relationship. Multivariate model of normal tissue complication probability (NTCP) will also be proposed.

Discussion

Tools and results developed in the BACCARAT study should allow improving prediction and prevention of potential lesions to cardiac normal tissues surrounding tumors and ultimately enhance patients’ care and quality of life.

Trial registration

ClinicalTrials.gov: NCT02605512

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Title: Early detection and prediction of cardiotoxicity after radiation therapy for breast cancer: the BACCARAT prospective cohort study
Authors: Sophie Jacob
Atul Pathak
Denis Franck
Igor Latorzeff
Gaelle Jimenez
Olivier Fondard
Matthieu Lapeyre
Daniel Colombier
Eric Bruguiere
Olivier Lairez
Benoit Fontenel
Fabien Milliat
Radia Tamarat
David Broggio
Sylvie Derreumaux
Marianne Ducassou
Jean Ferrières
Dominique Laurier
Marc Benderitter
Marie-Odile Bernier
Publication date: 01-12-2016
Publisher: BioMed Central
Published in: Radiation Oncology / Issue 1/2016
Electronic ISSN: 1748-717X
DOI: https://doi.org/10.1186/s13014-016-0627-5

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Early detection and prediction of cardiotoxicity after radiation therapy for breast cancer: the BACCARAT prospective cohort study

Abstract

Background

Methods/Design

Discussion

Trial registration

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods/Design

Discussion

Trial registration

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