Symptomatic cardiac toxicity is predicted by dosimetric and patient factors rather than changes in ¹⁸F-FDG PET determination of myocardial activity after chemoradiotherapy for esophageal cancer

详细信息    查看全文

• 作者：Andre Konski ; Tianyu Li ; Michael Christensen ; Jonathan D. Cheng ; Jian Q. Yu ; Kevin Crawford ; Oleh Haluszka ; Jeffrey Tokar ; Walter Scott ; Neal J. Meropol ; Steven J. Cohen ; Alan Maurer ; Gary M. Freedman
• 关键词：Chemoradiotherapy ; Esophageal cancer ; Cardiac toxicity
• 刊名：Radiotherapy and Oncology
• 出版年：2012
• 出版时间：July, 2012
• 年：2012
• 卷：104
• 期：1
• 页码：72-77
• 全文大小：179 K

文摘

Purpose

To determine factors associated with symptomatic cardiac toxicity in patients with esophageal cancer treated with chemoradiotherapy.

Material and methods

We retrospectively evaluated 102 patients treated with chemoradiotherapy for locally advanced esophageal cancer. Our primary endpoint was symptomatic cardiac toxicity. Radiation dosimetry, patient demographic factors, and myocardial changes seen on ¹⁸F-FDG PET were correlated with subsequent cardiac toxicity. Cardiac toxicity measured by RTOG and CTCAE v3.0 criteria was identified by chart review.

Results

During the follow up period, 12 patients were identified with treatment related cardiac toxicity, 6 of which were symptomatic. The mean heart V20 (79.7 % vs. 67.2 % , p = 0.05), V30 (75.8 % vs. 61.9 % , p = 0.04), and V40 (69.2 % vs. 53.8 % , p = 0.03) were significantly higher in patients with symptomatic cardiac toxicity than those without. We found the threshold for symptomatic cardiac toxicity to be a V20, V30 and V40 above 70 % , 65 % and 60 % , respectively. There was no correlation between change myocardial SUV on PET and cardiac toxicity, however, a greater proportion of women suffered symptomatic cardiac toxicity compared to men (p = 0.005).

Conclusions

A correlation did not exist between percent change in myocardial SUV and cardiac toxicity. Patients with symptomatic cardiac toxicity received significantly greater mean V20, 30 and 40 values to the heart compared to asymptomatic patients. These data need validation in a larger independent data set.