Cardiac Irradiation Predicts Activity Decline in Patients Receiving Concurrent Chemoradiation for Locally Advanced Lung Cancer
| Autor: | Justin Tang, Nitin Ohri, Madhur Garg, S. Paul, William Bodner |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Lung Neoplasms medicine.medical_treatment Urology Fitness Trackers 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Interquartile range Carcinoma Non-Small-Cell Lung medicine Humans Radiology Nuclear Medicine and imaging Esophagus Radiation Injuries Lung cancer Adverse effect Aged Aged 80 and over Clinical Trials as Topic Radiation Performance status business.industry Heart Radiotherapy Dosage Chemoradiotherapy Middle Aged Physical Functional Performance medicine.disease Small Cell Lung Carcinoma Confidence interval Radiation therapy medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis Cohort Female business |
| Zdroj: | International Journal of Radiation Oncology*Biology*Physics. 108:597-601 |
| ISSN: | 0360-3016 |
| Popis: | Purpose Many patients with lung cancer are inactive due to their disease and underlying comorbidities, and activity levels can decline further during cancer therapy. Here we explore dosimetric predictors of activity decline in a cohort of patients who underwent continuous activity monitoring during definitive concurrent chemoradiotherapy (CRT) for locally advanced lung cancer. Methods and Materials We identified patients who participated in prospective clinical trials involving the use of a commercial fitness tracker throughout the course of CRT. For each patient, we applied linear regression to log-transformed daily step counts to compute the weekly rate of activity change from 1 week before radiation therapy (RT) initiation to 2 weeks after RT completion. Clinical and dosimetric factors were tested as predictors of activity change using linear regressions. Results Forty-six patient met the eligibility criteria. Median age was 66 years (range, 38-90). Pretreatment Eastern Cooperative Oncology Group performance status was 0, 1, and 2 for 17%, 70%, and 13%, respectively. Mean lung dose ranged from 5.0 to 23.5 Gy, mean esophagus dose from 1.1 to 39.6 Gy, and mean heart dose from 0.6 to 31.5 Gy. Median daily step count average was 5861 (interquartile range, 3540-8282) before RT and 3422 (interquartile range, 2364-5395) 2 weeks after RT completion. Rate of activity change was not significantly associated with age, performance status, or mean RT dose received by lungs or esophagus. In multivariate analysis, mean heart dose was significantly associated with rate of activity decline, with a 3.1% reduction in step count per week for every 10 Gy increase in mean heart dose (95% confidence interval: 0.5-5.7, P = .023). Conclusions Extent of cardiac irradiation is associated with the rate of physical activity decline during CRT for lung cancer. Our novel finding contributes to the growing body of evidence that adverse effects of cardiac irradiation may be manifested at early time points. |
| Databáze: | OpenAIRE |
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