Cardiovascular death is greatly under-reported in people undergoing radiotherapy for non-small cell lung cancer (NSCLC), concludes a study carried out by Leeds Cancer Centre.
The study examined the burden of cardiac events post-radiotherapy and estimated the accuracy of death certification in patients who received radical radiotherapy for lung cancer.
The retrospective observational cohort study of patients who received radical radiotherapy for NSCLC at Leeds Cancer Centre between 1 January 2010 and 31 December 2016. Median follow-up was 34 months.
Of 1224 participants, 378 (30.9%) had cardiovascular disease (CVD) at baseline, including 140 (11.4%) with prior myocardial infarction.
In the 846 patients without known CVD, 451 (53.3%) had a QRISK2 predicted 10-year cardiovascular risk of >20% over 10 years.
During follow-up, 215 hospitalisations occurred which were classified as primarily cardiac, and 622 patients died. However, death certificates stated a primary cardiac cause of death in only 33 cases (5.3% of deaths).
Twenty-nine per cent of cancer deaths at home did not have cancer relapse prior to death, and 61 per cent received no community palliative care input. The authors say this data implied that these events may have been sudden and unexpected.
Presenting the findings in the journal Lung Cancer, the authors conclude that there is a high prevalence of baseline CVD in people undergoing radiotherapy for NSCLC, accompanied by significant rates of post-radiotherapy cardiovascular hospitalisation.
They say the small proportion of deaths attributed to CVD, together with the large number of sudden deaths observed, suggests cardiovascular death in this population is greatly under-reported in official statistics.
