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Chia Ching Lee
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P2.14 - Radiotherapy (ID 715)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Radiotherapy
- Presentations: 1
- Moderators:
- Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P2.14-002 - Impact of Pre-Existing Cardiac Disease and Heart Doses on Survival in Nsclc Treated with Post-Operative Thoracic Radiotherapy (ID 8530)
09:30 - 09:30 | Presenting Author(s): Chia Ching Lee
- Abstract
Background:
Recent randomized and observational studies suggested that pre-existing cardiac disease and higher radiation heart doses were associated with more cardiac events and worse overall survival (OS) in locally-advanced non-small cell lung cancer (NSCLC) treated with definitive chemoradiation. Post-operative thoracic radiotherapy (PORT) delivered via non-modern radiation techniques had also been shown to increase cardiac mortality. Hence we performed this study to determine the impact of pre-existing ischaemic heart disease and radiation heart dose on OS in NSCLC patients treated with PORT using contemporary radiation techniques.
Method:
Study eligibility criteria included stage I to III NSCLC treated with PORT at two institutions from 2007 to 2014. Clinical data and dosimetric parameters affecting overall survival were collected from the institutional electronic medical records as well as the national death and acute myocardial infarction registries. Univariate cox regression was performed using Stata version 13.
Result:
Twenty eligible patients were identified. Median follow-up duration was 30.4 months (2.3- 81.9). Median age was 59 years. Median prescription dose was 57 Gy. Median mean heart dose was 12Gy. 10% had pre-existing ischaemic heart disease. 75% underwent lobectomy. 60% had pathological stage III disease. 40% had left-sided disease. 70% received chemotherapy. The 1- and 2-year OS were 75% and 60% respectively. Univariate analysis showed that pre-existing ischaemic heart disease was significantly associated with worse OS (hazard ratio 7.13, 95% confidence interval 1.17-43.47, P value < 0.03). Mean heart dose and the other cardiac dosimetric parameters (volume of heart receiving ≥ 5, 25, 30, 40, 50Gy, and dose to ≥ 30% of heart volume) were not associated with OS.
Conclusion:
Pre-existing ischaemic heart disease was a significant predictor for worse OS in NSCLC patients treated with modern PORT. We plan to expand the cohort to confirm these findings. Patients should be screened for ischaemic heart disease and cardiac function optimised prior to PORT and on follow-up.
