ESTRO 2024 - Abstract Book

S1692

Clinical - Lung

ESTRO 2024

At a median follow-up of 15 (IQR: 7-29) months, 257 (31.3%%) patients experienced at least one new cardiac event, including 87 myocardial infarction, 83 atrial fibrillation, 38 atrioventricular block, 35 bundle branch block, 34 fascicular block, 28 atrial flutter, 16 severe arrhythmia, 14 coronary artery disease, 11 valvular disorder, 5 pericarditis, 3 pericardial effusion, 3 cardiomyopathy, 26 cardiac failure and 28 cardiac death. Following clinical parameters were associated with cardiac toxicity in multivariable analysis: age at RT>70 years (HR=1.36, 95% CI: 1.04-1.78), tumor located in mediastinum/hilum (HR=1.56, 95% CI: 1.02-2.39), history of cardiac disease (HR=1.54, 95% CI: 1.17-2.01), history of vascular disease (HR=1.33, 95% CI: 1.01-1.77), pacemaker (HR=1.95, 95% CI: 1.21-3.14), cisplatin-etoposide (HR=1.54, 95% CI: 1.08-2.19), carboplatin-etoposide (HR=1.94, 95% CI: 1.33 2.81), prolonged QRS interval in baseline ECG (HR=1.49, 95% CI: 1.10-2.02) and high potassium level (HR=0.62, 95% CI: 0.39-0.99) (Table 1). Significant dose- volume measures for predicting the risk of cardiac toxicity were: heart volume≥792 cc (HR=1.39, 95% CI: 1.03- 1.88), left atrium Dmax≥63 Gy (HR=1.53, 95% CI: 1.09 - 2.15), esophagus V20Gy≥1.3% (HR=1.37, 95% CI: 1.02- 1.84), left atrium volume≥69 cc (HR=1.41,95% CI: 1.05 -1.89), left lung Dmax<6 Gy (HR=1.75, 95% CI: 1.21-2.52) and right lung volume<2161 cc (HR=1.34, 95% CI: 1.04-1.72) (Figure 1).