ESTRO 2024 - Abstract Book

S1657

Clinical - Lung

ESTRO 2024

There were 11 CE – 4 myocardial infarction, 4 heart failure, 3 atrial fibrillation. There was no correlation between baseline or change in HsTnI, cholesterol or lymphocyte count and survival or cardiac events.

Baseline NT pro-BNP was significantly associated with survival accounting for age, stage, performance status, iGTV and MHD.

In the 37 patients who had cardiac imaging, median baseline Agatston score was 371 (0-3419). The median baseline left ventricular ejection fraction (LVEF) was 63% (28%-73%). There was no significant change in Agatston score or LVEF following radiotherapy and no relationship between imaging parameters and cardiac events or survival.

Conclusion:

This group of patients having thoracic radiotherapy had high coronary artery calcium prior to treatment. There was no change in LVEF or Agatston score over the study period however, the number of patients in the imaging study was small and larger studies of cardiac imaging in patients having thoracic radiotherapy are warranted. Cardiac troponin increased at the end of radiotherapy then returned to normal levels after 4-9 months and this rise correlated with MHD. Despite the observed rise in troponin, this did not correlate with outcome however, baseline NT-proBNP correlated with overall survival. This result suggests that acute heart muscle injury may not be responsible for early mortality seen in this cohort of patients and that sub-clinical cardiac damage, prior to radiotherapy, may be a more important predictor of survival.

Keywords: clinical trial, cardiac toxicity

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