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. 2015 Aug;10(4):277-80.
doi: 10.1159/000431030. Epub 2015 May 26.

Radiotherapy Induces Development of Fragmented QRS in Patients with Breast Cancer

Adem Adar  1 , Emine Canyılmaz  2 , Abdulkadir Kiris  3 , Abdulselam Ilter  3 , Lasif Serdar  2 , Yahyahan Memis  2 , Zumrut Bahat  2 , Orhan Onalan  1
Affiliations

Radiotherapy Induces Development of Fragmented QRS in Patients with Breast Cancer

Adem Adar et al. Breast Care (Basel). 2015 Aug.

Abstract

Background: Myocardial fibrosis is a well-known side effect of radiotherapy. Fragmented QRS (fQRS) has been shown to be a marker of myocardial fibrosis. We postulated that radiotherapy induces development of fQRS in breast cancer patients.

Patients and methods: Breast cancer patients receiving locoregional radiotherapy were enrolled. Patients who had fQRS on electrocardiography (ECG) before radiotherapy were excluded. All patients were revaluated for the development of fQRS at 1-year follow-up. An age-matched healthy group served as controls.

Results: A total of 52 breast cancer patients receiving locoregional radiotherapy were included (median age 49 years, interquartile range (IQR) 13). Of these, 19 (37%) had developed fQRS at 1-year follow-up. Compared with the control group, prevalence of fQRS was significantly higher in the irradiated group (37 vs. 12%; p < 0.002). Median total cardiac radiation dose was significantly higher in patients who had developed fQRS (5 Gy, IQR 5.2 vs. 1.7 Gy, IQR 4.4; p = 0.003). Cardiac radiation dose, entered either as a continuous variable (odds ratio (OR) 1.35, 95% confidence interval (CI) 104-1.74) or as a dichotomized variable (≥ 2.2 Gy, OR 6.48, 95% CI 1.47-28.61), was independently associated with the development of fQRS at 1-year follow-up.

Conclusion: Radiotherapy for breast cancer induces development of fQRS on ECG. Cardiac radiation dose is independently associated with the development of fQRS.

Keywords: Breast cancer; Fragmented QRS; Radiotherapy.

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Figures

Fig. 1
Fig. 1
Various forms of fragmented QRS on electrocardiography.
Fig. 2
Fig. 2
Receiver operating characteristic curve for the presence of fragmented QRS on electrocardiography.
See this image and copyright information in PMC

References

    1. Youlden DR, Cramb SM, Dunn NA, Muller JM, Pyke CM, Baade PD. The descriptive epidemiology of female breast cancer: an international comparison of screening, incidence, survival and mortality. Cancer Epidemiol. 2012;36:237–248. - PubMed
    1. Darby S, McGale P, Correa C, Taylor C, Arriagada R, Clarke M, Cutter D, Davies C, Ewertz M, Godwin J, Gray R, Pierce L, Whelan T, Wang Y, Peto R, Early Breast Cancer Trialists' Collaborative G Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10,801 women in 17 randomised trials. Lancet. 2011;378:1707–1716. - PMC - PubMed
    1. van der Hage JA, van de Velde CJ, Julien JP, Floiras JL, Delozier T, Vandervelden C, Duchateau L. Improved survival after one course of perioperative chemotherapy in early breast cancer patients. long-term results from the European Organization for Research and Treatment of Cancer (EORTC) Trial 10854. Eur J Cancer. 2001;37:2184–2193. - PubMed
    1. Davies C, Godwin J, Gray R, Clarke M, Cutter D, Darby S, McGale P, Pan HC, Taylor C, Wang YC, Dowsett M, Ingle J, Peto R, Early Breast Cancer Trialists' Collaborative Group Relevance of breast cancer hormone receptors and other factors to the efficacy of adjuvant tamoxifen: patient-level meta-analysis of randomised trials. Lancet. 2011;378:771–784. - PMC - PubMed
    1. Jaworski C, Mariani JA, Wheeler G, Kaye DM. Cardiac complications of thoracic irradiation. J Am Coll Cardiol. 2013;61:2319–2328. - PubMed

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