Are heart doses associated with survival in patients with non-small cell lung cancer who received post-operative thoracic radiotherapy?: A national population-based study
The aim of this retrospective national cohort study is to assess the association between various radiation heart dosimetric parameters (RHDPs), acute myocardial infarct (AMI) and overall survival (OS) outcomes in non-small cell lung cancer (NSCLC) patients treated with post-operative thoracic radiot...
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| Veröffentlicht in: | Medicine (Baltimore) 2019-08, Vol.98 (35), p.e17020-e17020 |
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| creator | Lee, Chia Ching Chua, Gail Wan Ying Zheng, Huili Soon, Yu Yang Foo, Ling Li Thiagarajan, Anuradha Yap, Swee Peng Siow, Tian Rui Ng, Wee Loon Chua, Kevin Lee Min Yip, Connie Chia, Brendan Seng Hup Ng, Yan Yee Master, Zubin Tan, Poh Wee Tan, Yun Inn Leong, Yuh Fun Loria, Joan Faith Evacula Vellayappan, Balamurugan Koh, Wee Yao Leong, Cheng Nang Tey, Jeremy Chee Seong Tham, Ivan Weng Keong Fong, Kam Weng |
| description | The aim of this retrospective national cohort study is to assess the association between various radiation heart dosimetric parameters (RHDPs), acute myocardial infarct (AMI) and overall survival (OS) outcomes in non-small cell lung cancer (NSCLC) patients treated with post-operative thoracic radiotherapy (PORT) using contemporary radiation techniques.We identified patients with stage I to III NSCLC treated with PORT at the 2 national cancer institutions from 2007 to 2014. We linked their electronic medical records to the national AMI and death registries. Univariable Cox regression was performed to assess the association between various RHDPs, AMI, and OS.We included 43 eligible patients with median follow-up of 36.6 months. Median age was 64 years. Majority of the patients had pathological stage III disease (72%). Median prescription dose was 60Gy. Median mean heart dose (MHD) was 9.4Gy. There were no AMI events. The 5-year OS was 34%. Univariable Cox regression showed that age was significantly associated with OS (hazard ratio, 1.06; 95% confidence interval, 1.01 to 1.10; P = .008). Radiation heart doses, including MHD, volume of heart receiving at least 5, 25, 30, 40, 50Gy and dose to 30% of heart volume, were not significantly associated with OS.There is insufficient evidence to conclude that RHDPs are associated with OS for patients with NSCLC treated with PORT in this study. Studies with larger sample size and longer term follow-up are needed to assess AMI outcome. |
| doi_str_mv | 10.1097/MD.0000000000017020 |
| format | Article |
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We linked their electronic medical records to the national AMI and death registries. Univariable Cox regression was performed to assess the association between various RHDPs, AMI, and OS.We included 43 eligible patients with median follow-up of 36.6 months. Median age was 64 years. Majority of the patients had pathological stage III disease (72%). Median prescription dose was 60Gy. Median mean heart dose (MHD) was 9.4Gy. There were no AMI events. The 5-year OS was 34%. Univariable Cox regression showed that age was significantly associated with OS (hazard ratio, 1.06; 95% confidence interval, 1.01 to 1.10; P = .008). Radiation heart doses, including MHD, volume of heart receiving at least 5, 25, 30, 40, 50Gy and dose to 30% of heart volume, were not significantly associated with OS.There is insufficient evidence to conclude that RHDPs are associated with OS for patients with NSCLC treated with PORT in this study. Studies with larger sample size and longer term follow-up are needed to assess AMI outcome.</description><identifier>ISSN: 0025-7974</identifier><identifier>EISSN: 1536-5964</identifier><identifier>DOI: 10.1097/MD.0000000000017020</identifier><identifier>PMID: 31464961</identifier><language>eng</language><publisher>United States: the Author(s). Published by Wolters Kluwer Health, Inc</publisher><subject>Age Factors ; Aged ; Carcinoma, Non-Small-Cell Lung - epidemiology ; Carcinoma, Non-Small-Cell Lung - mortality ; Carcinoma, Non-Small-Cell Lung - radiotherapy ; Female ; Humans ; Lung Neoplasms - epidemiology ; Lung Neoplasms - mortality ; Lung Neoplasms - radiotherapy ; Male ; Middle Aged ; Myocardial Infarction - epidemiology ; Neoplasm Staging ; Observational Study ; Proportional Hazards Models ; Radiotherapy Dosage ; Retrospective Studies</subject><ispartof>Medicine (Baltimore), 2019-08, Vol.98 (35), p.e17020-e17020</ispartof><rights>the Author(s). Published by Wolters Kluwer Health, Inc.</rights><rights>Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc. 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3553-93d4d7eb404d528a52cdb1ac4ebc6acbfdd4357af8f3d70accaabb17e87acd573</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6736475/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6736475/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31464961$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lee, Chia Ching</creatorcontrib><creatorcontrib>Chua, Gail Wan Ying</creatorcontrib><creatorcontrib>Zheng, Huili</creatorcontrib><creatorcontrib>Soon, Yu Yang</creatorcontrib><creatorcontrib>Foo, Ling Li</creatorcontrib><creatorcontrib>Thiagarajan, Anuradha</creatorcontrib><creatorcontrib>Yap, Swee Peng</creatorcontrib><creatorcontrib>Siow, Tian Rui</creatorcontrib><creatorcontrib>Ng, Wee Loon</creatorcontrib><creatorcontrib>Chua, Kevin Lee Min</creatorcontrib><creatorcontrib>Yip, Connie</creatorcontrib><creatorcontrib>Chia, Brendan Seng Hup</creatorcontrib><creatorcontrib>Ng, Yan Yee</creatorcontrib><creatorcontrib>Master, Zubin</creatorcontrib><creatorcontrib>Tan, Poh Wee</creatorcontrib><creatorcontrib>Tan, Yun Inn</creatorcontrib><creatorcontrib>Leong, Yuh Fun</creatorcontrib><creatorcontrib>Loria, Joan Faith Evacula</creatorcontrib><creatorcontrib>Vellayappan, Balamurugan</creatorcontrib><creatorcontrib>Koh, Wee Yao</creatorcontrib><creatorcontrib>Leong, Cheng Nang</creatorcontrib><creatorcontrib>Tey, Jeremy Chee Seong</creatorcontrib><creatorcontrib>Tham, Ivan Weng Keong</creatorcontrib><creatorcontrib>Fong, Kam Weng</creatorcontrib><title>Are heart doses associated with survival in patients with non-small cell lung cancer who received post-operative thoracic radiotherapy?: A national population-based study</title><title>Medicine (Baltimore)</title><addtitle>Medicine (Baltimore)</addtitle><description>The aim of this retrospective national cohort study is to assess the association between various radiation heart dosimetric parameters (RHDPs), acute myocardial infarct (AMI) and overall survival (OS) outcomes in non-small cell lung cancer (NSCLC) patients treated with post-operative thoracic radiotherapy (PORT) using contemporary radiation techniques.We identified patients with stage I to III NSCLC treated with PORT at the 2 national cancer institutions from 2007 to 2014. We linked their electronic medical records to the national AMI and death registries. Univariable Cox regression was performed to assess the association between various RHDPs, AMI, and OS.We included 43 eligible patients with median follow-up of 36.6 months. Median age was 64 years. Majority of the patients had pathological stage III disease (72%). Median prescription dose was 60Gy. Median mean heart dose (MHD) was 9.4Gy. There were no AMI events. The 5-year OS was 34%. Univariable Cox regression showed that age was significantly associated with OS (hazard ratio, 1.06; 95% confidence interval, 1.01 to 1.10; P = .008). Radiation heart doses, including MHD, volume of heart receiving at least 5, 25, 30, 40, 50Gy and dose to 30% of heart volume, were not significantly associated with OS.There is insufficient evidence to conclude that RHDPs are associated with OS for patients with NSCLC treated with PORT in this study. Studies with larger sample size and longer term follow-up are needed to assess AMI outcome.</description><subject>Age Factors</subject><subject>Aged</subject><subject>Carcinoma, Non-Small-Cell Lung - epidemiology</subject><subject>Carcinoma, Non-Small-Cell Lung - mortality</subject><subject>Carcinoma, Non-Small-Cell Lung - radiotherapy</subject><subject>Female</subject><subject>Humans</subject><subject>Lung Neoplasms - epidemiology</subject><subject>Lung Neoplasms - mortality</subject><subject>Lung Neoplasms - radiotherapy</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Myocardial Infarction - epidemiology</subject><subject>Neoplasm Staging</subject><subject>Observational Study</subject><subject>Proportional Hazards Models</subject><subject>Radiotherapy Dosage</subject><subject>Retrospective Studies</subject><issn>0025-7974</issn><issn>1536-5964</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkctu1TAQhiMEoofCEyAhL9mkOL7ECQvQUctNasUG1tbEnjSGnDjYTo7OK_GUuD2lXLywNTPf_GP7L4rnFT2raKteXV2c0T-rUpTRB8WmkrwuZVuLh8WGUiZL1SpxUjyJ8VuGuGLicXHCK1GLtq42xc9tQDIghESsjxgJxOiNg4SW7F0aSFzC6lYYiZvIDMnhlOKxMvmpjDsYR2Iwb-MyXRMDk8FA9oMnAQ26NcvMPqbSzxhy94okDT6AcYYEsM6nIefnw9vXZEumDPgpj5r9vIy3QdlBzBIxLfbwtHjUwxjx2d15Wnx9_-7L-cfy8vOHT-fby9JwKXnZciuswk5QYSVrQDJjuwqMwM7UYLreWsGlgr7puVUUjAHoukpho8BYqfhp8eaoOy_dDq3JLw4w6jm4HYSD9uD0v5XJDfrar7pWvBZKZoGXdwLB_1gwJr1z8eaPYEK_RM1Yw4RQtG0zyo-oCT7GgP39mIrqG5f11YX-3-Xc9eLvG973_LY1A-II7P2YMMTv47LHoLPPYxpu9aRqWclo1dKGU1rmjOL8FxbHuWM</recordid><startdate>20190801</startdate><enddate>20190801</enddate><creator>Lee, Chia Ching</creator><creator>Chua, Gail Wan Ying</creator><creator>Zheng, Huili</creator><creator>Soon, Yu Yang</creator><creator>Foo, Ling Li</creator><creator>Thiagarajan, Anuradha</creator><creator>Yap, Swee Peng</creator><creator>Siow, Tian Rui</creator><creator>Ng, Wee Loon</creator><creator>Chua, Kevin Lee Min</creator><creator>Yip, Connie</creator><creator>Chia, Brendan Seng Hup</creator><creator>Ng, Yan Yee</creator><creator>Master, Zubin</creator><creator>Tan, Poh Wee</creator><creator>Tan, Yun Inn</creator><creator>Leong, Yuh Fun</creator><creator>Loria, Joan Faith Evacula</creator><creator>Vellayappan, Balamurugan</creator><creator>Koh, Wee Yao</creator><creator>Leong, Cheng Nang</creator><creator>Tey, Jeremy Chee Seong</creator><creator>Tham, Ivan Weng Keong</creator><creator>Fong, Kam Weng</creator><general>the Author(s). Published by Wolters Kluwer Health, Inc</general><general>Wolters Kluwer Health</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20190801</creationdate><title>Are heart doses associated with survival in patients with non-small cell lung cancer who received post-operative thoracic radiotherapy?: A national population-based study</title><author>Lee, Chia Ching ; Chua, Gail Wan Ying ; Zheng, Huili ; Soon, Yu Yang ; Foo, Ling Li ; Thiagarajan, Anuradha ; Yap, Swee Peng ; Siow, Tian Rui ; Ng, Wee Loon ; Chua, Kevin Lee Min ; Yip, Connie ; Chia, Brendan Seng Hup ; Ng, Yan Yee ; Master, Zubin ; Tan, Poh Wee ; Tan, Yun Inn ; Leong, Yuh Fun ; Loria, Joan Faith Evacula ; Vellayappan, Balamurugan ; Koh, Wee Yao ; Leong, Cheng Nang ; Tey, Jeremy Chee Seong ; Tham, Ivan Weng Keong ; Fong, Kam Weng</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3553-93d4d7eb404d528a52cdb1ac4ebc6acbfdd4357af8f3d70accaabb17e87acd573</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Age Factors</topic><topic>Aged</topic><topic>Carcinoma, Non-Small-Cell Lung - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Medicine (Baltimore)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lee, Chia Ching</au><au>Chua, Gail Wan Ying</au><au>Zheng, Huili</au><au>Soon, Yu Yang</au><au>Foo, Ling Li</au><au>Thiagarajan, Anuradha</au><au>Yap, Swee Peng</au><au>Siow, Tian Rui</au><au>Ng, Wee Loon</au><au>Chua, Kevin Lee Min</au><au>Yip, Connie</au><au>Chia, Brendan Seng Hup</au><au>Ng, Yan Yee</au><au>Master, Zubin</au><au>Tan, Poh Wee</au><au>Tan, Yun Inn</au><au>Leong, Yuh Fun</au><au>Loria, Joan Faith Evacula</au><au>Vellayappan, Balamurugan</au><au>Koh, Wee Yao</au><au>Leong, Cheng Nang</au><au>Tey, Jeremy Chee Seong</au><au>Tham, Ivan Weng Keong</au><au>Fong, Kam Weng</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Are heart doses associated with survival in patients with non-small cell lung cancer who received post-operative thoracic radiotherapy?: A national population-based study</atitle><jtitle>Medicine (Baltimore)</jtitle><addtitle>Medicine (Baltimore)</addtitle><date>2019-08-01</date><risdate>2019</risdate><volume>98</volume><issue>35</issue><spage>e17020</spage><epage>e17020</epage><pages>e17020-e17020</pages><issn>0025-7974</issn><eissn>1536-5964</eissn><abstract>The aim of this retrospective national cohort study is to assess the association between various radiation heart dosimetric parameters (RHDPs), acute myocardial infarct (AMI) and overall survival (OS) outcomes in non-small cell lung cancer (NSCLC) patients treated with post-operative thoracic radiotherapy (PORT) using contemporary radiation techniques.We identified patients with stage I to III NSCLC treated with PORT at the 2 national cancer institutions from 2007 to 2014. We linked their electronic medical records to the national AMI and death registries. Univariable Cox regression was performed to assess the association between various RHDPs, AMI, and OS.We included 43 eligible patients with median follow-up of 36.6 months. Median age was 64 years. Majority of the patients had pathological stage III disease (72%). Median prescription dose was 60Gy. Median mean heart dose (MHD) was 9.4Gy. There were no AMI events. The 5-year OS was 34%. Univariable Cox regression showed that age was significantly associated with OS (hazard ratio, 1.06; 95% confidence interval, 1.01 to 1.10; P = .008). Radiation heart doses, including MHD, volume of heart receiving at least 5, 25, 30, 40, 50Gy and dose to 30% of heart volume, were not significantly associated with OS.There is insufficient evidence to conclude that RHDPs are associated with OS for patients with NSCLC treated with PORT in this study. Studies with larger sample size and longer term follow-up are needed to assess AMI outcome.</abstract><cop>United States</cop><pub>the Author(s). Published by Wolters Kluwer Health, Inc</pub><pmid>31464961</pmid><doi>10.1097/MD.0000000000017020</doi><oa>free_for_read</oa></addata></record> |
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| source | Wolters Kluwer Open Health; MEDLINE; DOAJ Directory of Open Access Journals; IngentaConnect Free/Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Alma/SFX Local Collection |
| subjects | Age Factors Aged Carcinoma, Non-Small-Cell Lung - epidemiology Carcinoma, Non-Small-Cell Lung - mortality Carcinoma, Non-Small-Cell Lung - radiotherapy Female Humans Lung Neoplasms - epidemiology Lung Neoplasms - mortality Lung Neoplasms - radiotherapy Male Middle Aged Myocardial Infarction - epidemiology Neoplasm Staging Observational Study Proportional Hazards Models Radiotherapy Dosage Retrospective Studies |
| title | Are heart doses associated with survival in patients with non-small cell lung cancer who received post-operative thoracic radiotherapy?: A national population-based study |
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