LS-SCLC: left-sided disease tied to higher cardiac mortality

  • Verma V & al.
  • Radiother Oncol
  • 19 Jun 2018

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • Patients with limited-stage small-cell lung cancer (LS-SCLC) with left-sided disease have significantly higher cardiac-specific mortality (CSM) compared with those with right-sided disease.
  • Among right-sided patients, radiotherapy (RT) conveyed better cardiac-specific survival but had the opposite effect in left-sided disease.

Why this matters

  • Data on cardiotoxicity among patients with LS-SCLC receiving radiotherapy are lacking.

Study design

  • 19,692 patients with LS-SCLC from the Surveillance, Epidemiology, and End Results database.
  • Funding: None.

Key results

  • 41% of patients were left-sided and 59% were right-sided.
  • 7.8% of deaths were cardiac-related within 3 years of initial diagnosis, 5.0% at 3-4 years, and 7.2% at 4-5 years.
  • Overall, left-sided patients experienced similar overall mortality to their right-sided counterparts, but significantly higher CSM (3.3% vs 2.6%; P=.004, HR for CSM, 1.27; 95% CI, 1.08-1.50).
  • Among patients with right-sided disease, those who underwent RT had better cardiac-specific survival compared with those who did not (P<.001>
  • Among patients with left-sided disease, those who underwent RT had worse cardiac-specific survival than those who did not (P<.001>
  • On multivariable Cox analysis, patients with left-sided disease had a greater risk for CSM (HR, 1.26; 95% CI, 1.07-1.50).

Limitations

  • Study cannot confirm causation between RT and CSM.

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