Coronary Artery Calcifications and Cardiac Risk After Radiation Therapy for Stage III Lung Cancer
| Autor: | Carrie B. Lee, Mary Oakey, Jeffrey Fenoli, Brian C. Jensen, Lawrence B. Marks, Allison M. Deal, Hillary M. Heiling, Nicholas D. Patchett, Hayley E. Malkin, Kyle Wang, Thomas E. Stinchcombe, Kevin A. Pearlstein, Panayiotis Mavroidis, Sean McCabe, Ashley A. Weiner, J. Larry Klein |
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| Rok vydání: | 2022 |
| Předmět: |
Risk
Cancer Research medicine.medical_specialty Lung Neoplasms Heart Diseases Heart disease medicine.medical_treatment Coronary Artery Disease Article Coronary artery disease Pericarditis Carcinoma Non-Small-Cell Lung Internal medicine Humans Medicine Radiology Nuclear Medicine and imaging Cumulative incidence Prospective Studies Neoplasm Staging Radiation Radiotherapy business.industry Unstable angina Hazard ratio medicine.disease Radiation therapy Oncology Heart failure Cardiology business |
| Zdroj: | Int J Radiat Oncol Biol Phys |
| ISSN: | 0360-3016 |
| DOI: | 10.1016/j.ijrobp.2021.08.017 |
| Popis: | PURPOSE: Heart dose and heart disease increase risk for RT-associated cardiac toxicity. We hypothesized that CT coronary calcifications are associated with cardiac toxicity and may help ascertain baseline heart disease. METHODS AND MATERIALS: We analyzed the cumulative incidence of cardiac events in patients with Stage III non-small-cell lung cancer receiving median 74 Gy on prospective dose-escalation trials. Events were defined as symptomatic effusion, pericarditis, unstable angina, infarction, significant arrhythmia, and/or heart failure. Coronary calcifications were delineated on simulation CT’s using MIM (130 HU threshold). Calcifications were defined “None,” “Low,” and “High,” with median volume dividing Low and High. RESULTS: Of 109 patients, 26 had cardiac events at median 26 months (range, 1-84 months) post-RT. Median follow-up in surviving patients was 8.8 years (range, 2.3-17.3). On simulation CT’s, 64 (59%) had coronary calcifications with median volume 0.2 cc (range 0.01-8.3). Only 16 patients (15%) had baseline coronary artery disease. Cardiac events occurred in 7% (3/45), 29% (9/31), and 42% (14/33) of patients with No, Low, and High calcifications, respectively. Calcification burden was associated with cardiac toxicity on univariate (Low vs. None: HR 5.0, p=0.015, High vs. None: HR 8.1, p |
| Databáze: | OpenAIRE |
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