为肺癌接受放射治疗的患者心脏功能变化
Ivy S Han1, Kyunga Ko2, Jennifer Wei Zou3
1Division of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
针对非小细胞肺癌 (NSCLC) 的放射治疗可能会导致暂时的心脏功能障碍,特别是影响左心室喷射率 (LVEF). 整体心脏V30是与这些下降相关的关键剂量指标,突出了其在辐射规划中的重要性.
科学领域:
- 心脏病学 心脏病学
- 在瘤学瘤学.
- 放射学 放射学是一门学科.
背景情况:
- 在非小细胞肺癌 (NSCLC) 患者的放射治疗 (RT) 的心血管毒性尚未完全理解.
- 心声学变化及其与心脏剂量-体积指标的相关性需要进一步调查.
研究的目的:
- 在NSCLC患者的RT后评估心脏结构和功能的回声心脏学参数的变化.
- 为了确定这些心声回声学变化和心脏剂量-体积指标之间的关联.
主要方法:
- 一项多中心前性队列研究,涉及NSCLC患者接受胸部RT.
- 心声图在基线,RT结束以及RT后6个月和12个月收集.
- 重复测量多变量线性回归分析了心声学测量和剂量-体积关联的变化.
主要成果:
- 在RT后观察到左心室喷射分数 (LVEF),全球纵向应变和周围应变的适度,大部分可逆下降.
- 心脏功能障碍 (LVEF下降≥10%至<50%) 在7.2%的参与者中发生.
- 平均心脏剂量 (MHD) 和整个心脏V30与LVEF下降有关,在调整后,整个心脏V30仍然显著.
结论:
- 在NSCLC患者中的RT导致适度的,暂时的心脏功能变化,其中一个子集经历了显著的功能障碍.
- 整体心脏V30是RT规划的相关指标,因为它与LVEF下降有关.
- 对新型剂量-体积测量措施的进一步研究是有必要的.
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