TY - JOUR
T1 - Cardiac comorbidity is an independent risk factor for radiation-induced lung toxicity in lung cancer patients
AU - Nalbantov, Georgi
AU - Kietselaer, Bas
AU - Vandecasteele, Katrien
AU - Oberije, Cary
AU - Berbee, Maaike
AU - Troost, Esther
AU - Dingemans, Anne Marie
AU - Baardwijk, Angela Van
AU - Smits, Kim
AU - Dekker, André
AU - Bussink, Johan
AU - Ruysscher, Dirk De
AU - Lievens, Yolande
AU - Lambin, Philippe
PY - 2013/10
Y1 - 2013/10
N2 - 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.
AB - 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.
KW - Cardiac comorbidity
KW - Dyspnea
KW - Lung cancer
KW - Radiation-induced lung toxicity
KW - Radiotherapy
U2 - 10.1016/j.radonc.2013.08.035
DO - 10.1016/j.radonc.2013.08.035
M3 - Article
C2 - 24044794
SN - 0167-8140
VL - 109
SP - 100
EP - 106
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
IS - 1
ER -