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. 2019 Nov 22;14(11):e0225685. doi: 10.1371/journal.pone.0225685. eCollection 2019.


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.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Ataxia Telangiectasia Mutated Proteins / genetics*
  • Breast Neoplasms / pathology
  • Breast Neoplasms / radiotherapy
  • Female
  • Gamma Rays / adverse effects*
  • Gamma Rays / therapeutic use
  • Genotype
  • Humans
  • Polymorphism, Single Nucleotide
  • Proportional Hazards Models
  • Skin Diseases / diagnosis
  • Skin Diseases / etiology*
  • Telangiectasis / diagnosis
  • Telangiectasis / etiology


  • ATM protein, human
  • Ataxia Telangiectasia Mutated Proteins

Grant support

The authors received no specific funding for this work.