ESTRO 2024 - Abstract Book

S1718

Clinical - Lung

ESTRO 2024

With respect to prescribing cardiovascular medications, participants were most frequently very/quite comfortable prescribing statins (33%) and aspirin (32%). There was a trend for decreased preparedness to prescribe all cardiovascular drugs with increasing seniority ( Figure 2 ). The importance of having a local cardio-oncology service was rated as very/quite important, uncertain and little/no importance by 69%, 28% and 3%. A distinct cardio oncology service was available to 39% participants, while the remainder utilise general cardiology services. Only select patients are referred to cardiology before radiotherapy by most participants 85%, and 18% had institutional criteria. The most common barriers to cardiology involvement were cardiologist time (56%), resources (46%), cardiologist interest (40%), while oncologist time (34%) and interest (22%) and a lack of evidence (20%) were less common barriers.

Conclusion:

This is the first cross-sectional survey of thoracic radiation oncologists regarding global practice and opinions on radiation cardiotoxicity in NSCLC. The uptake of recent guidelines on cardiovascular optimisation is good, but access to cardiology investigations and consultations are a barrier to cardiology liaison for patients with NSCLC. Auto segmentation is regarded as a key barrier to implementation of substructure dose constraints. Some physicians have already incorporated dose constraints into practice, with the most common constraint being the LAD V15 <15%. More junior physicians felt more prepared to prescribe cardiovascular drugs, but there was a consensus that establishing local cardio-oncology services is important.

Keywords: Cardiotoxicity, radiotherapy, practice survey

References:

1. Wang K, Eblan MJ, Deal AM, Lipner M, Zagar TM, Wang Y, et al. Cardiac Toxicity After Radiotherapy for Stage III Non-Small-Cell Lung Cancer: Pooled Analysis of Dose-Escalation Trials Delivering 70 to 90 Gy. J Clin Oncol [Internet]. 2017 May 1 [cited 2022 Oct 29];35(13):1387 – 94. Available from: https://pubmed.ncbi.nlm.nih.gov/28113017/ 2. Dess RT, Sun Y, Matuszak MM, Sun G, Soni PD, Bazzi L, et al. Cardiac Events After Radiation Therapy: Combined Analysis of Prospective Multicenter Trials for Locally Advanced Non-Small-Cell Lung Cancer. J Clin Oncol [Internet]. 2017 May 1 [cited 2022 Dec 9];35(13):1395 – 402. Available from: https://pubmed.ncbi.nlm.nih.gov/28301264/