Late cardiac toxicity of neo-adjuvant chemoradiation in esophageal cancer survivors
| Autor: | Jannet C. Beukema, Crystal de Groot, John T.M. Plukker, Rozemarijn Vliegenthart, Johannes A. Langendijk, Peter van Luijk, Joost P. van Melle, Niek H.J. Prakken, Christina T. Muijs |
|---|---|
| Přispěvatelé: | Guided Treatment in Optimal Selected Cancer Patients (GUTS), Damage and Repair in Cancer Development and Cancer Treatment (DARE), Cardiovascular Centre (CVC), Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE), Targeted Gynaecologic Oncology (TARGON) |
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
Esophageal Neoplasms
IMPACT Esophageal cancer Contrast Media Gadolinium Pilot Projects HEART-DISEASE CHEMORADIOTHERAPY Radiation toxicity Humans Radiology Nuclear Medicine and imaging Prospective Studies Survivors RADIATION MODALITY USE RISK MORTALITY Hematology Chemoradiotherapy Adjuvant QUANTIFICATION Cardiac toxicity Fibrosis LOW QRS VOLTAGE Cardiotoxicity Neoadjuvant Therapy Cross-Sectional Studies Oncology ATRIAL-FIBRILLATION Quality of Life RADIOTHERAPY |
| Zdroj: | Radiotherapy and Oncology, 167, 72-77. ELSEVIER IRELAND LTD |
| ISSN: | 0167-8140 |
| Popis: | Purpose: Although cure rates in esophageal cancer (EC) have improved since the introduction of neoadjuvant chemoradiation (nCRT), evidence for treatment-related cardiac toxicity is growing, of which the exact mechanisms remain unknown. The primary objective of this study was to identify (subclinical) cardiac dysfunction in EC patients after nCRT followed by surgical resection as compared to surgery alone.Materials and Methods: EC survivors followed for 5-15 years after curative resection with (n = 20) or without (n = 20) nCRT were enrolled in this prospective cross-sectional pilot study. All patients underwent several clinical and diagnostic tests in order to objectify (sub)clinical cardiac toxicity including cardiac CT and MRI, echocardiography, ECG, 6-minutes walking test, physical examination and EORTC questionnaires.Results: We found an increased rate of myocardial fibrosis (Linear late gadolinium enhancement (LGE) 4 vs. 1; p = 0.13; mean extracellular volume (ECV) 28.4 vs. 24.0; p < 0.01), atrial fibrillation (AF) (6 vs. 2; p = 0.07) and conduction changes in ECG among patients treated with nCRT as compared to those treated with surgery alone. The results suggested an impact on quality of life in terms of worse role functioning for this patient group (95.0 vs. 88.8; p = 0.03).Conclusion: Based on our analyses we hypothesize that in EC patients, radiation-induced myocardial fibrosis plays a central role in cardiac toxicity leading to AF, conduction changes and ultimately to decreased role functioning. The results emphasize the need to verify these findings in larger cohorts of patients. (C) 2021 The Author(s). Published by Elsevier B.V. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect