Top Line: Over the past few years, we’ve learned a lot about how radiation dose to cardiac substructures may influence the risk of cardiac events in lung cancer patients.
The Study: Among these adverse cardiac events, one of the most common arrhythmias is atrial fibrillation. Afib is often caused by abnormal myocardial tissue at the junction of the pulmonary veins and the left atrium. This retrospective study of 420 patients treated with radiation +/- chemo for NSCLC sought to determine whether dose to the pulmonary veins was associated with Afib risk. After treatment, 6% of patients developed new onset Afib. Dose to the left and right pulmonary veins was significantly associated with the risk of developing Afib. On the left, the V55 was most strongly associated with Afib risk while on the right it was the V10. Median V10 and V55 for the right pulmonary veins were 55% and 0%. Median V10 and V55, and mean dose for the left pulmonary veins were 84.1% and 0%. The optimal cutoffs for Afib risk were right pulmonary vein V10 <54% and left pulmonary vein V55 <2%. It remains to be seen whether optimizing dose to cardiac structures, including the pulmonary veins, would reduce the risk of cardiac events.
TBL: This retrospective study associated dose to the pulmonary veins with risk of Afib in patients receiving radiation for NSCLC. | Walls, Radiother Oncol 2024
The Study: Among these adverse cardiac events, one of the most common arrhythmias is atrial fibrillation. Afib is often caused by abnormal myocardial tissue at the junction of the pulmonary veins and the left atrium. This retrospective study of 420 patients treated with radiation +/- chemo for NSCLC sought to determine whether dose to the pulmonary veins was associated with Afib risk. After treatment, 6% of patients developed new onset Afib. Dose to the left and right pulmonary veins was significantly associated with the risk of developing Afib. On the left, the V55 was most strongly associated with Afib risk while on the right it was the V10. Median V10 and V55 for the right pulmonary veins were 55% and 0%. Median V10 and V55, and mean dose for the left pulmonary veins were 84.1% and 0%. The optimal cutoffs for Afib risk were right pulmonary vein V10 <54% and left pulmonary vein V55 <2%. It remains to be seen whether optimizing dose to cardiac structures, including the pulmonary veins, would reduce the risk of cardiac events.
TBL: This retrospective study associated dose to the pulmonary veins with risk of Afib in patients receiving radiation for NSCLC. | Walls, Radiother Oncol 2024