ESTRO 2024 - Abstract Book

S1783

Clinical - Lung

ESTRO 2024

2815

Digital Poster

Clinical and dosimetric predictors of cardiac toxicity in radiotherapy for stage III NSCLC

Marianna Miele 1 , Edy Ippolito 2 , Gian Marco Petrianni 1 , Aurelia Iurato 1 , Cecilia Sciommari 1 , Lucrezia Toppi 1 , Teresa Insero 1 , Michele Fiore 2 , Carlo Greco 2 , Martina Benincasa 1 , Miriam Carpenito 3 , Simona Mega 3 , Francesco Grigioni 4 , Sara Ramella 2 1 Operative Research Unit of Radiation Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy. 2 Research Unit of Radiation Oncology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Rome, Italy. 3 Operative Research Unit of Cardiology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy. 4 Research Unit of Cardiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Rome, Italy

Purpose/Objective:

The aim of this study was to prospectively investigate predictors of early heart damage in patients with locally advanced non small cell lung cancer (LA-NSCLC) undergoing chemoradiotherapy (CRT).

Material/Methods:

This trial is a prospective, observational cohort study including patients with stage IIIA-IIIB NSCLC who underwent concomitant chemoradiotherapy (CRT). Radiotherapy was delivered with a median total dose of 60 Gy with conventional fractionation. The 3D technique or Intesity-modulated radiotherapy (IMRT) was used. Manual contouring of the target and organs at risk (OAR) was performed from the simulation CT images. The differences in cardiac dosimetry and clinical and treatment factors between patients who have experienced cardiac and no cardiac events (CV) were assessed by means of T-test (continuous variables) and Chi-Quadro (discrete variables). Dosimetric parameters and clinical or treatment factors that resulted different between patients who experienced CV and those who did not (p<0.05), were included in the univariate regression analysis. Variables with a p< 0.1 at univariable analysis and without significant cross-correlations (Pearson or Spearmen coefficient) were entered into multivariate logistic regression. ROC curves were used to assess the cut-off point for the risk of developing CV events.

Results:

This analysis included thirty-four patients with stage IIIA-IIIB NSCLC. The median age was 69.5 years (range, 43-87). The median follow-up was 27.8 months. 62% of patients were in stage IIIA. All patients were treated with concurrent CRT, and a platinum-based regimen was used in 65% of cases. No patients died of CV complications. Eight patients (23.5%) had a CV event: four atrial fibrillation, two supraventricular tachycardia, one atrioventricular block (second degree), and one patient presented heart failure. No patients presented coronary events. The heart dosimetric parameters analyzed and clinical and treatment factors evaluated were described in Table 1. Table 2 shows univariate and multivariate analysis results. At univariate analysis, the predictors of increased risk of cardiovascular