Cardio-oncology & otherCohort study

Predicting Adverse Cardiac Events After Radiotherapy for Locally Advanced Non–Small Cell Lung Cancer

JACC CardioOncolPublished

  • Retrospective cohort study

Authors' conclusion

Adverse cardiac events associated with radiation occur in more than 20% of patients undergoing thoracic radiotherapy within a median time of <2 years. The present findings provide further evidence to support significant associations between TotalLeft radiotherapy dose and cardiac events and define CAC as a predictive risk factor.

Study context

Population
Patients with locally advanced non-small cell lung cancer treated with radiotherapy (2006–2018)
Participants
233 patients
Outcome
Grade ≥3 adverse cardiac events; associations with cardiac substructure dose and CAC scores

Main finding

As reported in the abstract

Grade ≥3 cardiac events
competing-risk multivariable model
Hazard ratio (95% CI)P value
TotalLeft volume receiving 15 Gy (per 1 cc)
1.38(1.11–1.72)
P = 0.004
CAC score >5
2.51(1.08–5.86)
P = 0.033

Per 1 cc, as printed

Cardiac events after radiotherapy
22.3%
Median time to cardiac event
21.5 months (range: 1.7-118.9 months)

Observational data: associations, not effects.

Further findings

Cardiac event incidence by risk model (age, TotalLeft CAC >5, volume receiving 15 Gy)

P < 0.001

Visual vs automated coronary artery calcium (CAC) scoring correlation

r
0.72; P < 0.001

Original publication

Predicting Adverse Cardiac Events After Radiotherapy for Locally Advanced Non–Small Cell Lung Cancer. JACC CardioOncol. Published 4 October 2023. doi:10.1016/j.jaccao.2023.08.007

Summarised from the published abstract; every number is checked against it