Vrijednosti visokoosjetljivog troponina I kod adjuvantnog hipofrakcioniranog zračenja lijeve dojke uz konkomitantnu primjenu anti-HER2 terapije

doctoral thesis

• Title (english): High - sensitive Troponin I values in patients with left-sided breast cancer undergoing hypofractionated adjuvant radiotherapy with concurrent anti-HER2 therapy
• Author: Katarina Antunac
• Mentor: Lidija Beketić-Orešković (mentor)
• Committee member: Fedor Šantek (predsjednik povjerenstva)
• Committee member: Boško Skorić (član povjerenstva)
• Committee member: Ljubica Vazdar (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2024-07-03, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Radiotherapy and Oncology
• Universal decimal classification (UDC): 616 - Pathology. Clinical medicine

Abstract

Cilj našeg istraživanja je evaluirati utjecaj doze zračenja na srčane strukture na vrijednosti visokoosjetljivog Troponina I (hscTnI) kao ranog biljega kardiotoksičnosti kod bolesnica s HER2 pozitivnim rakom lijeve dojke koje provode adjuvantnu radioterapiju konkomitantno s anti-HER2 terapijom koristeći trastuzumab, kombinaciju trastuzumab - pertuzumab ili trastuzumab emtanzin te ustanoviti korelaciju vrijednosti hscTnI s dozama zračenja na srčane strukture. Kod 61 bolesnice vrijednosti hscTnI su mjerene prije početka i po završetku radioterapije. Izrađeni su dozno volumni histogrami za srce, lijevu klijetku (LV) te prednju lijevu silaznu arteriju (LAD). Porast vrijednosti hscTnI je zabilježen kod 17 bolesnica (Grupa 1). Bolesnice u ovoj skupini imale su značajno veću srednju dozu zračenja na srce (p = 0,02), LV (p = 0,03) i LAD (p = 0,04) te AUC za srce i LV (p = 0,01 za oba) u odnosu na bolesnice bez porasta hscTnI (Grupa 2). Kod bolesnica u Grupi 1 veći volumen srca i LV su primili dozu od 2 Gy (p = 0,01 za oba) i 4 Gy (p = 0,02 za oba) te je veći volumen LAD-a primio dozu od 2 Gy (p = 0,03), 4 Gy (p = 0,02) i 5 Gy (p = 0,02). Opažena je pozitivna korelacija porasta vrijednosti hscTnI s dozama zračenja na srce, LV i LAD.

Abstract (english)

Aim of this study was to evaluate the influence of radiation dose on cardiac structures on the values of early cardiotoxicity marker high sensitivity cardiac troponin I (hscTnI) in patients with HER2 positive left breast cancer undergoing adjuvant radiotherapy concomitantly with anti-HER2 therapy (using either trastuzumab, combination of trastuzumab and pertuzumab or trastuzumab emtansine) and to establish correlation of hscTnI values with cardiac radiation doses. In 61 patients hscTnI values were measured prior to and upon completion of radiotherapy. Dose volume histograms were generated for heart, left ventricle (LV) and left anterior descending artery (LAD). An increase of hscTnI values was observed in 17 patients (Group 1). These patients had significantly higher mean radiation doses for the heart (p = 0.02), LV (p = 0.03) and LAD (p = 0.04) and AUC for heart and LV (p = 0.01 for both) than patients without hscTnI increase (Group 2). Patients in Group 1 had larger volumes of heart and LV receiving 2 Gy (p = 0.01 for both) and 4 Gy (p = 0.02 for both) and larger volumes of LAD receiving 2 Gy (p = 0.03), 4 Gy (p = 0.02) and 5 Gy (p = 0.02). The increase of hscTnI was positively correlated with radiation doses on the heart, LV and LAD.

• Keywords: rak dojke; HER2 pozitivni rak dojke; adjuvantna radioterapija; hipofrakcionirano zračenje; kardiotoksičnost; visokoosjetljivi Troponin I (hsTI); trastuzumab; pertuzumab; trastuzumab emtanzin
• Keywords (english): breast cancer; HER2 positive breast cancer; adjuvant radiotherapy; radiotherapy dose hypofractionation; cardiotoxicity; high-sensitivity Troponin I (hsTI); trastuzumab; pertuzumab; trastuzumab emtansine
• Language: croatian
• URN:NBN: urn:nbn:hr:105:921865
• Study programme: Title: Biomedicine and Health Sciences; Study programme type: university; Study level: postgraduate; Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstvo (doktor/doktorica znanosti, područje biomedicine i zdravstvo)
• Type of resource: Text
• Extent: 161 str.
• File origin: Born digital
• Access conditions: Open access
• Created on: 2024-07-08 08:30:25