Journal
RADIOTHERAPY AND ONCOLOGY
Volume 109, Issue 1, Pages 100-106Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.radonc.2013.08.035
Keywords
Lung cancer; Cardiac comorbidity; Radiotherapy; Dyspnea; Radiation-induced lung toxicity
Funding
- CTMM
- EU
- Interreg
- STW (DuCAT)
- Kankeronderzoekfonds Limburg from the Health Foundation Limburg
- Dutch Cancer Society [KWF UM 2011-5020, 5020, KWF UM 2009-4454]
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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 >= 2 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. (C) 2013 The Authors. Published by Elsevier Ireland Ltd. All rights reserved.
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