Radiotherapy and Cardiovascular Disease Survival Risk in Non-Small Cell Lung Cancer: A Population-Based Study From...

It is well known that radiotherapy increases the cardiovascular risk of cancer patients, but there are few large-sample studies with cardiovasular-specific death as the endpoint in lung cancer patients.

Patients aged ≥ 18 years diagnosed with non-small cell lung cancer were retrospectively enrolled from the Surveillance, Epidemiology, and End Results (SEER) database spanning the years 2004 to 2021. Multivariate Cox proportional hazards regression model was employed to assess prognostic factors influencing survival outcomes.

A total of 89,569 patients met the eligibility criteria and were analyzed. Multivariate analysis did not find the effect of radiotherapy on CVD-specific survival in the population with non-small cell lung cancer (p = 0.58). Subgroup analysis was conducted on the queues before matching. Radiation therapy was found to be predictive of a higher risk of CVD-specific survival in regional patients (HR, 1.68, 95% CI 1.1-2.59) and in those with stage III (HR, 2.16, 95% CI 1.26-3.69). We explored the relationship between radiotherapy and CVD-specific survival at different follow-up times after diagnosis, and found that radiotherapy was a risk factor for CVD-specific survival in populations followed up for less than 2 years and 3-4 years.

Our analysis suggested that radiotherapy markedly amplified the risk of CVD-specific survival in regional patients and those categorized as stage III. It is notable that in the patient cohort with a follow-up period of less than 2 years, radiotherapy also became an independent risk factor for cardiovascular-related survival in this group of patients.