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Impact of ATM rs1801516 on late skin reactions of radiotherapy for breast cancer: Evidences from a cohort study and a trial sequential meta-analysis

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  • Salvatore Terrazzino
  • Sarah Cargnin
  • Letizia Deantonio
  • Carla Pisani
  • Laura Masini
  • Pier Luigi Canonico
  • Armando A Genazzani
  • Marco Krengli

Abstract

The relationship between the ataxia-telangiectasia mutated (ATM) rs1801516 gene polymorphism and risk of radiation-induced late skin side effects remains a highly debated issue. In the present study, we assessed the role of ATM rs1801516 as risk factor for radiation-induced fibrosis and telangiectasia, using the LENT-SOMA scoring scale in 285 breast cancer patients who received radiotherapy after breast conserving surgery. A systematic review with meta-analysis and trial sequential analysis (TSA) was then conducted to assess reliability of the accumulated evidence in breast cancer patients. In our cohort study, no association was found between ATM rs1801516 and grade ≥ 2 telangiectasia (GA+AA vs GG, HRadjusted: 0.699; 95%CI: 0.273–1.792, P = 0.459) or grade ≥ 2 fibrosis (GA+AA vs GG, HRadjusted: 1.175; 95%CI: 0.641–2.154, P = 0.604). Twelve independent cohorts of breast cancer patients were identified through the systematic review, of which 11 and 9 cohorts focused respectively on the association with radiation-induced fibrosis and radiation-induced telangiectasia. Pooled analyses of 10 (n = 2928 patients) and 12 (n = 2783) cohorts revealed, respectively, no association of ATM rs1801516 with radiation-induced telangiectasia (OR: 1.14; 95%CI: 0.88–1.48, P = 0.316) and a significant correlation with radiation-induced fibrosis (OR: 1.23; 95%CI: 1.00–1.51, P = 0.049), which however did not remain significant after TSA adjustment (TSA-adjusted 95%CI: 0.85–1.78). These results do not support an impact of ATM rs1801516 on late skin reactions of radiotherapy for breast cancer, nevertheless further large studies are still required for conclusive evidences.

Suggested Citation

  • Salvatore Terrazzino & Sarah Cargnin & Letizia Deantonio & Carla Pisani & Laura Masini & Pier Luigi Canonico & Armando A Genazzani & Marco Krengli, 2019. "Impact of ATM rs1801516 on late skin reactions of radiotherapy for breast cancer: Evidences from a cohort study and a trial sequential meta-analysis," PLOS ONE, Public Library of Science, vol. 14(11), pages 1-21, November.
    • Handle: RePEc:plo:pone00:0225685
    DOI: 10.1371/journal.pone.0225685
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    References listed on IDEAS

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    1. Christopher J. Bakkenist & Michael B. Kastan, 2003. "DNA damage activates ATM through intermolecular autophosphorylation and dimer dissociation," Nature, Nature, vol. 421(6922), pages 499-506, January.
    2. Mei-Ling Zhu & MengYun Wang & Ting-Yan Shi & Qiao-Xin Li & Pan Xi & Kai-Qin Xia & Leizhen Zheng & Qing-Yi Wei, 2013. "No Association between TGFB1 Polymorphisms and Late Radiotherapy Toxicity: A Meta-Analysis," PLOS ONE, Public Library of Science, vol. 8(10), pages 1-1, October.
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