Sang-Geon Cho1, Yong-Hyub Kim2, Hyukjin Park3, Ki Seong Park1, Jahae Kim1, Sung-Ja Ahn4, Hee-Seung Bom5. 1. Department of Nuclear Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea. 2. Department of Radiation Oncology, Chonnam National University Hwasun Hospital, 322, Seoyang-ro, Hwasun-gun, Jeonnam, 58128, Republic of Korea. 3. Department of Cardiololgy, Chonnam National University Hwasun Hospital, Jeonnam, Republic of Korea. 4. Department of Radiation Oncology, Chonnam National University Hwasun Hospital, 322, Seoyang-ro, Hwasun-gun, Jeonnam, 58128, Republic of Korea. ahnsja@jnu.ac.kr. 5. Department of Nuclear Medicine, Chonnam National University Hwasun Hospital, 322, Seoyang-ro, Hwasun-gun, Jeonnam, 58128, Republic of Korea. hsbom@jnu.ac.kr.
Abstract
OBJECTIVE: No imaging biomarkers are available for the prediction of cardiac events following concurrent chemoradiation therapy (CCRT) for non-small-cell lung cancer (NSCLC). We evaluated whether F-18 fluorodeoxyglucose positron emission tomography (FDG PET) early after CCRT, in addition to cardiac dosimetry, could predict late cardiac events in NSCLC. METHODS: We retrospectively enrolled 133 consecutive patients with locally advanced, unresectable stage III NSCLC, who underwent FDG PET early after CCRT and survived at least 6 months. The primary endpoint was cardiac event ≥ grade 2 according to the Common Terminology Criteria for Adverse Events (version 5.0). Myocardial FDG uptake was measured and its association with the risk of cardiac events was evaluated. RESULTS: FDG PET was performed after a median interval of 11 days of completing CCRT. Overall, 42 (32%) patients experienced cardiac events during a median follow-up of 45 months. The mean heart dose, maximum left ventricular (LV) standardized uptake value (SUV), changes in maximum and mean LV SUV, right ventricular uptake, tumor stage, white blood cell count, and diabetes were associated with cardiac events in univariable analysis. In multivariable analysis, maximum LV SUV (cutoff > 12.84; hazard ratio [95% confidence interval] = 2.140 [1.140-4.016]; p = 0.018) was an independent predictor of cardiac events along with the mean heart dose (> 11.1 Gy; 3.646 [1.792-7.417]; p < 0.001) and tumor stage (IIIB; 1.986 [1.056-3.734]; p = 0.033). It remained predictive of cardiac events in those with higher mean heart dose but not in those with lower mean heart dose. CONCLUSIONS: Early FDG PET after CCRT for NSCLC could aid in predicting late cardiac events, especially in patients with higher mean heart dose.
OBJECTIVE: No imaging biomarkers are available for the prediction of cardiac events following concurrent chemoradiation therapy (CCRT) for non-small-cell lung cancer (NSCLC). We evaluated whether F-18 fluorodeoxyglucose positron emission tomography (FDG PET) early after CCRT, in addition to cardiac dosimetry, could predict late cardiac events in NSCLC. METHODS: We retrospectively enrolled 133 consecutive patients with locally advanced, unresectable stage III NSCLC, who underwent FDG PET early after CCRT and survived at least 6 months. The primary endpoint was cardiac event ≥ grade 2 according to the Common Terminology Criteria for Adverse Events (version 5.0). Myocardial FDG uptake was measured and its association with the risk of cardiac events was evaluated. RESULTS: FDG PET was performed after a median interval of 11 days of completing CCRT. Overall, 42 (32%) patients experienced cardiac events during a median follow-up of 45 months. The mean heart dose, maximum left ventricular (LV) standardized uptake value (SUV), changes in maximum and mean LV SUV, right ventricular uptake, tumor stage, white blood cell count, and diabetes were associated with cardiac events in univariable analysis. In multivariable analysis, maximum LV SUV (cutoff > 12.84; hazard ratio [95% confidence interval] = 2.140 [1.140-4.016]; p = 0.018) was an independent predictor of cardiac events along with the mean heart dose (> 11.1 Gy; 3.646 [1.792-7.417]; p < 0.001) and tumor stage (IIIB; 1.986 [1.056-3.734]; p = 0.033). It remained predictive of cardiac events in those with higher mean heart dose but not in those with lower mean heart dose. CONCLUSIONS: Early FDG PET after CCRT for NSCLC could aid in predicting late cardiac events, especially in patients with higher mean heart dose.
Authors: Yevgeniy Vinogradskiy; Quentin Diot; Bernard Jones; Richard Castillo; Edward Castillo; Jennifer Kwak; Daniel Bowles; Inga Grills; Nicholas Myziuk; Thomas Guerrero; Craig Stevens; Tracey Schefter; Laurie E Gaspar; Brian Kavanagh; Moyed Miften; Chad Rusthoven Journal: Int J Radiat Oncol Biol Phys Date: 2020-01-23 Impact factor: 7.038
Authors: Jaden D Evans; Daniel R Gomez; Joe Y Chang; Gregory W Gladish; Jeremy J Erasmus; Neal Rebueno; Jose Banchs; Ritsuko Komaki; James W Welsh Journal: Radiother Oncol Date: 2013-09-07 Impact factor: 6.280
Authors: Jeffrey D Bradley; Rebecca Paulus; Ritsuko Komaki; Gregory Masters; George Blumenschein; Steven Schild; Jeffrey Bogart; Chen Hu; Kenneth Forster; Anthony Magliocco; Vivek Kavadi; Yolanda I Garces; Samir Narayan; Puneeth Iyengar; Cliff Robinson; Raymond B Wynn; Christopher Koprowski; Joanne Meng; Jonathan Beitler; Rakesh Gaur; Walter Curran; Hak Choy Journal: Lancet Oncol Date: 2015-01-16 Impact factor: 41.316
Authors: Sarah C Darby; Marianne Ewertz; Paul McGale; Anna M Bennet; Ulla Blom-Goldman; Dorthe Brønnum; Candace Correa; David Cutter; Giovanna Gagliardi; Bruna Gigante; Maj-Britt Jensen; Andrew Nisbet; Richard Peto; Kazem Rahimi; Carolyn Taylor; Per Hall Journal: N Engl J Med Date: 2013-03-14 Impact factor: 91.245
Authors: Ronald Boellaard; Roberto Delgado-Bolton; Wim J G Oyen; Francesco Giammarile; Klaus Tatsch; Wolfgang Eschner; Fred J Verzijlbergen; Sally F Barrington; Lucy C Pike; Wolfgang A Weber; Sigrid Stroobants; Dominique Delbeke; Kevin J Donohoe; Scott Holbrook; Michael M Graham; Giorgio Testanera; Otto S Hoekstra; Josee Zijlstra; Eric Visser; Corneline J Hoekstra; Jan Pruim; Antoon Willemsen; Bertjan Arends; Jörg Kotzerke; Andreas Bockisch; Thomas Beyer; Arturo Chiti; Bernd J Krause Journal: Eur J Nucl Med Mol Imaging Date: 2014-12-02 Impact factor: 9.236