Cardiac comorbidity is an independent risk factor for radiation-induced lung toxicity in lung cancer patients

Georgi Nalbantov*, Bas Kietselaer, Katrien Vandecasteele, Cary Oberije, Maaike Berbee, Esther Troost, Anne Marie Dingemans, Angela Van Baardwijk, Kim Smits, André Dekker, Johan Bussink, Dirk De Ruysscher, Yolande Lievens, Philippe Lambin

*Corresponding author for this work

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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 ( 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. ?? 2013 Elsevier Ireland Ltd. All rights reserved.
Original languageEnglish
Pages (from-to)100-106
Number of pages7
JournalRadiotherapy and Oncology
Issue number1
Publication statusPublished - Oct 2013


  • Cardiac comorbidity
  • Dyspnea
  • Lung cancer
  • Radiation-induced lung toxicity
  • Radiotherapy

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