Radiation ups cardiac risk in lung cancer

  • J Am Coll Cardiol

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • Cardiac radiation dose was an independent predictor of major adverse cardiac events (MACE) and all-cause mortality within 2 years of radiotherapy for locally advanced NSCLC.

Why this matters

  • Despite the short life expectancy of lung cancer, patients with stage II-III NSCLC may benefit from a lower cardiac radiation dose, preventative cardiac treatment after radiotherapy, and earlier recognition and treatment of cardiovascular problems.

Study design

  • 748 patients with stage II-III NSCLC received a treatment regimen that included thoracic radiotherapy at a median prescription radiation tumor dose of 66.0 Gy and a median mean radiation heart dose (mean heart dose [MHD]) of 12.3 Gy.
  • Median follow-up, 20.4 months.
  • Funding: None disclosed.

Key results

  • 10.3% of patients developed ≥1 MACE and was significantly more likely in CHD-positive patients (18.7% vs 5.6%; P<.0001>
  • Increasing MHD was associated with significantly higher risk for MACE (aHR, 1.05/Gy; P<.001 and all-cause mortality p=".003).</li">
  • In CHD-negative patients, treatment with MHD ≥10 Gy vs
  • No association with MHD and MACE or all-cause mortality in CHD-positive patients.

Limitations

  • Single-center, retrospective study.