Changes in Cardiac Function in Patients Receiving Radiation Therapy for Lung Cancer

Area of Science:

• Cardiology
• Oncology
• Radiology

Background:

• Cardiovascular toxicity from radiation therapy (RT) in non-small cell lung cancer (NSCLC) patients is not fully understood.
• Echocardiographic changes and their correlation with cardiac dose-volume metrics require further investigation.

Purpose of the Study:

• To assess changes in echocardiographic parameters of cardiac structure and function following RT in NSCLC patients.
• To identify associations between these echocardiographic changes and cardiac dose-volume metrics.

Main Methods:

• A multi-center, prospective cohort study involving NSCLC patients undergoing thoracic RT.
• Echocardiograms were collected at baseline, end of RT, and at 6 and 12 months post-RT.
• Repeated-measures multivariable linear regression analyzed changes in echocardiographic measures and dose-volume associations.

Main Results:

• Modest, largely reversible declines in left ventricular ejection fraction (LVEF), global longitudinal strain, and circumferential strain were observed post-RT.
• Cardiac dysfunction (LVEF decline ≥10% to <50%) occurred in 7.2% of participants.
• Mean heart dose (MHD) and whole heart V30 were associated with LVEF declines, with whole heart V30 remaining significant after adjustment.

Conclusions:

• RT in NSCLC patients leads to modest, temporary cardiac function changes, with a subset experiencing significant dysfunction.
• Whole heart V30 is a relevant metric for RT planning due to its association with LVEF decline.
• Further research into novel dose-volume measures is warranted.