NSCLC: lower cardiac dose constraints needed for radiation treatment

  • Dess RT & al.
  • Pract Radiat Oncol
  • 2 Aug 2019

  • curated by Craig Hicks
  • Univadis Clinical Summaries
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • One-quarter of patients undergoing radiation treatment for locally advanced NSCLC receive a mean heart dose exceeding 20 Gy, a level linked to cardiac event rates ≥20% at 2 years.

Why this matters

  • Ionizing radiation dose to the heart during NSCLC treatment is strongly associated with inferior survival; treatment approaches are needed that meet dose constraints without compromising disease management goals.

Study design

  • Researchers studied patients with stage 3 NSCLC treated with radiation within a statewide consortium of 22 oncology clinics (N=746; mean age, 67 years; 54% men; left-sided primary disease, 38%; N2/N3 disease, 80%).
  • They surveyed sites within the consortium to assess established dose constraints.
  • Funding: Blue Cross Blue Shield of Michigan; Blue Care Network.

Key results

  • Median mean heart dose was 12 Gy (interquartile range, 5-19 Gy).
  • Percentage of heart volume exceeding a 30-Gy dose threshold (V30Gy) was >50% in 5% of cases; V40Gy was >35% in 3% of cases.
  • 16 (89%) of 18 responding clinics used cardiac dose constraints, but none was consistently applied across the consortium.
  • V30Gy was the most common dose level, used by 80% of clinics; the most common threshold was V30Gy≤50%.
  • No clinic used low dose constraints (

Limitations

  • Lack of cardiac morbidity, cardiac mortality, and overall survival outcomes preclude strong recommendations on specific dose constraints.

Please confirm your acceptance

To gain full access to GPnotebook please confirm:

By submitting here you confirm that you have accepted Terms of Use and Privacy Policy of GPnotebook.

Submit