TY  - JOUR
AU  - Koppelmans, Vincent
AU  - de Groot, Marius
AU  - de Ruiter, Michiel B
AU  - Boogerd, Willem
AU  - Seynaeve, Caroline
AU  - Vernooij, Meike W
AU  - Niessen, Wiro J
AU  - Schagen, Sanne B
AU  - Breteler, Monique M B
TI  - Global and focal white matter integrity in breast cancer survivors 20 years after adjuvant chemotherapy.
JO  - Human brain mapping
VL  - 35
IS  - 3
SN  - 1065-9471
CY  - New York, NY
PB  - Wiley-Liss
M1  - DZNE-2020-03680
SP  - 889-899
PY  - 2014
AB  - To date, only four small studies have investigated the effects of adjuvant chemotherapy for breast cancer on the microstructure of cerebral white matter with magnetic resonance imaging (MRI). These studies, which were conducted shortly up to 10 years post-treatment, showed that chemotherapy is associated with focal loss of microstructural white matter integrity. We investigated the long-term effect of chemotherapy on white matter microstructural integrity by comparing the brains of chemotherapy-exposed breast cancer survivors to those of a population-based sample of women without a history of cancer.Diffusion tensor imaging (DTI) MRI (1.5 T) was performed in 187 CMF (cyclophosphamide, methotrexate, and 5-flourouracil) chemotherapy-exposed breast cancer survivors, mean age 64.2 (sd = 6.5) years, who had been diagnosed with cancer on average 21.2 (sd = 4.4) years before, and 374 age-matched cancer-free reference subjects from a population-based cohort study. Outcome measures were whole-brain microstructural integrity as measured by fractional anisotropy and mean/axial/radial diffusivity and focal white matter integrity, which was analyzed with tract-based spatial statistics. All analyses were adjusted for age, cardiovascular risk factors, education, and symptoms of depression.No significant group differences were observed in white matter integrity. However, within the breast cancer survivors, time since treatment was inversely associated with lower global and focal white matter integrity.This cross-sectional study suggests that among chemotherapy-exposed breast cancer survivors white matter microstructural integrity deteriorates with accumulating time since treatment. This warrants further investigation.
KW  - Aged
KW  - Antineoplastic Agents: adverse effects
KW  - Antineoplastic Combined Chemotherapy Protocols: adverse effects
KW  - Brain: drug effects
KW  - Brain: pathology
KW  - Breast Neoplasms: drug therapy
KW  - Chemotherapy, Adjuvant: adverse effects
KW  - Cross-Sectional Studies
KW  - Cyclophosphamide: administration & dosage
KW  - Cyclophosphamide: adverse effects
KW  - Diffusion Tensor Imaging: instrumentation
KW  - Diffusion Tensor Imaging: methods
KW  - Female
KW  - Fluorouracil: administration & dosage
KW  - Fluorouracil: adverse effects
KW  - Humans
KW  - Leukoencephalopathies: chemically induced
KW  - Leukoencephalopathies: pathology
KW  - Methotrexate: administration & dosage
KW  - Methotrexate: adverse effects
KW  - Middle Aged
KW  - Survivors
KW  - Time Factors
KW  - Antineoplastic Agents (NLM Chemicals)
KW  - Cyclophosphamide (NLM Chemicals)
KW  - Fluorouracil (NLM Chemicals)
KW  - Methotrexate (NLM Chemicals)
LB  - PUB:(DE-HGF)16
C6  - pmid:23281152
DO  - DOI:10.1002/hbm.22221
UR  - https://pub.dzne.de/record/137358
ER  -