- 作者：Georgi Nalbantov ; Bas Kietselaer ; Katrien V ; ecasteele ; Cary Oberije ; Maaike Berbee ; Esther Troost ; Anne-Marie Dingemans ; Angela van Baardwijk ; Kim Smits ; Andr茅 Dekker ; Johan Bussink ; Dirk De Ruysscher ; Yol ; e Lievens ; Philippe Lambin
- 关键词：Lung cancer ; Cardiac comorbidity ; Radiotherapy ; Dyspnea ; Radiation-induced lung toxicity
- 刊名：Radiotherapy and Oncology
- 出版年：October, 2013
- 年：2013
- 卷：109
- 期：1
- 页码：100-106
- 全文大小：501 K
Purpose
To test the hypothesis that cardiac comorbidity before the start of radiotherapy (RT) is associated with an increased risk of radiation-induced lung toxicity (RILT) in lung cancer patients.Material and methods
A retrospective analysis was performed of a prospective cohort of 259 patients with locoregional lung cancer treated with definitive radio(chemo)therapy between 2007 and 2011 (ClinicalTrials.gov Identifiers: NCT00572325 and NCT00573040). We defined RILT as dyspnea CTCv.3.0 grade 猢? within 6 months after RT, and cardiac comorbidity as a recorded treatment of a cardiac pathology at a cardiology department. Univariate and multivariate analyses, as well as external validation, were performed. The model-performance measure was the area under the receiver operating characteristic curve (AUC).
Results
Prior to RT, 75/259 (28.9%) patients had cardiac comorbidity, 44% of whom (33/75) developed RILT. The odds ratio of developing RILT for patients with cardiac comorbidity was 2.58 (p < 0.01). The cross-validated AUC of a model with cardiac comorbidity, tumor location, forced expiratory volume in 1 s, sequential chemotherapy and pretreatment dyspnea score was 0.72 (p < 0.001) on the training set, and 0.67 (p < 0.001) on the validation set.
Conclusion
Cardiac comorbidity is an important risk factor for developing RILT after definite radio(chemo)therapy of lung cancer patients.