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Y. Ragulin



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    P3.03 - Poster Session/ Treatment of Locoregional Disease – NSCLC (ID 214)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Treatment of Locoregional Disease – NSCLC
    • Presentations: 1
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      P3.03-030 - Evaluation of the Functional Heart Condition During Radiotherapy for Lung Cancer (ID 2200)

      09:30 - 09:30  |  Author(s): Y. Ragulin

      • Abstract
      • Slides

      Background:
      Alterations in cardiac function appearing immediately during radiation therapy for lung cancer are insufficiently studied. It is necessary to continue studying alterations in left ventricular systolic and diastolic function arising during radiotherapy for lung cancer to prevent other complications. We aimed to study the functional state of the left ventricle during radiotherapy for lung cancer.

      Methods:
      The study included 39 patients with lung cancer. Irradiation was performed with a total radiation dose (TRD) of 60 Gy and a single radiation dose (SRD) of 1+1.5 Gy delivered from two different treatment fields. Initial echocardiographic examinations were carried out before starting radiotherapy in order to assess the functional state of the heart. Subsequently, the patients were followed up during radiotherapy with TRD of 20 Gy, 40 Gy, and 60 Gy. The following parameters were evaluated: left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV), stroke volume (SV), ejection fraction (EF), ratio of early and late diastolic filling rates of the left ventricle (E/A), motion rate of the lateral part of the fibrous ring of the mitral valve in early diastole (Еа), motion rate of the lateral part of the fibrous ring of the mitral valve in late diastole (Аа), ratio of motion rates of the lateral part of the fibrous ring of the mitral valve in early and late diastole (Еа/Аа).

      Results:
      At dose 20 Gy, left ventricular end diastolic volume decreased by 13%, and at TRD of 60 Gy – by 20%. At TRD of 20 Gy, left ventricular end systolic volume was altered by 9%, and at TRD of 60 Gy – by 14%. At TRD of 20 Gy, stroke volume decreased by 16%, and at TRD of 60 Gy – by 32% compared to the initial level. At TRD of 20 Gy, the ejection fraction decreased by 9 %, and at TRD of 60 Gy – by 23%. The parameters of left ventricular diastolic function were found to be reduced as well. At TRD of 20 Gy, the ratio of filling rates of the left ventricle in early and late diastole decreased by 4% and at TRD of 60 Gy – by 18%. At TRD of 20 Gy, the motion rate of the lateral part of the fibrous ring of the mitral valve in early diastole decreased by 10% and at TRD of 60 Gy – by 20%. At TRD of 20 Gy, the ratio of motion rates of the lateral part of the fibrous ring of the mitral valve in early and late diastoles decreased by 12%, and at TRD of 60 Gy – by 21%. Thus, an increase in radiation dose led to a decrease in left ventricular systolic and diastolic function.

      Conclusion:
      Radiation therapy for lung cancer significantly alters left ventricular systolic and diastolic function. Increased radiation doses cause the growth in the number of altered parameters.

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