PURPOSE: Chemoradiation is the standard treatment in patients with locally advanced non-small-cell lung cancer (LA-NSCLC), and thanks to the recent combination with immunotherapy, median survival has unexpectedly improved. This study aims to evaluate early changes in cardiac function after chemoradiotherapy (CRT) in LA-NSCLC by multimodal use of advanced imaging techniques. MATERIALS AND METHODS: This is a prospective, observational cohort study. At the beginning of combined treatment, screening tests including blood samples, electrocardiogram (ECG), echocardiographic examination (TTE), and cardiac magnetic resonance were performed in all patients with LA-NSCLC. ECG and cardiac marker assays were performed weekly during treatment. ECG and TTE were performed at month 1 (M1) and month 3 (M3) after the end of CRT. RESULTS: This preliminary analysis included thirty-four patients with a mean age of 69.5 years. The median follow-up was 27.8 months. 62% of patients were in stage IIIA. Radiation therapy was delivered with a median total dose of 60 Gy with conventional fractionation. All patients were treated with concurrent CRT, and 65% of cases were platinum-based therapy. Global longitudinal strain (GLS) and ejection fraction (EF) progressively decreased from baseline to M1 and M3. There was a strong correlation between GLS and EF reduction (at M1: p = 0.034; at M3: p = 0.018). Cardiac arrhythmias occurred in eight patients (23.5%) at a mean follow-up of 15.8 months after CRT. CONCLUSIONS: Reduction in GLS is an early sign occurring after the end of CRT for LA-NSCLC. Future studies are needed to identify variables that can increase the risk of cardiac events in this patient population to implement adequate damage prevention strategies.
PURPOSE: Chemoradiation is the standard treatment in patients with locally advanced non-small-cell lung cancer (LA-NSCLC), and thanks to the recent combination with immunotherapy, median survival has unexpectedly improved. This study aims to evaluate early changes in cardiac function after chemoradiotherapy (CRT) in LA-NSCLC by multimodal use of advanced imaging techniques. MATERIALS AND METHODS: This is a prospective, observational cohort study. At the beginning of combined treatment, screening tests including blood samples, electrocardiogram (ECG), echocardiographic examination (TTE), and cardiac magnetic resonance were performed in all patients with LA-NSCLC. ECG and cardiac marker assays were performed weekly during treatment. ECG and TTE were performed at month 1 (M1) and month 3 (M3) after the end of CRT. RESULTS: This preliminary analysis included thirty-four patients with a mean age of 69.5 years. The median follow-up was 27.8 months. 62% of patients were in stage IIIA. Radiation therapy was delivered with a median total dose of 60 Gy with conventional fractionation. All patients were treated with concurrent CRT, and 65% of cases were platinum-based therapy. Global longitudinal strain (GLS) and ejection fraction (EF) progressively decreased from baseline to M1 and M3. There was a strong correlation between GLS and EF reduction (at M1: p = 0.034; at M3: p = 0.018). Cardiac arrhythmias occurred in eight patients (23.5%) at a mean follow-up of 15.8 months after CRT. CONCLUSIONS: Reduction in GLS is an early sign occurring after the end of CRT for LA-NSCLC. Future studies are needed to identify variables that can increase the risk of cardiac events in this patient population to implement adequate damage prevention strategies.
Authors: Patrizio Lancellotti; Vuyisile T Nkomo; Luigi P Badano; Jutta Bergler-Klein; Jutta Bergler; Jan Bogaert; Laurent Davin; Bernard Cosyns; Philippe Coucke; Raluca Dulgheru; Thor Edvardsen; Oliver Gaemperli; Maurizio Galderisi; Brian Griffin; Paul A Heidenreich; Koen Nieman; Juan C Plana; Steven C Port; Marielle Scherrer-Crosbie; Ronald G Schwartz; Igal A Sebag; Jens-Uwe Voigt; Samuel Wann; Phillip C Yang Journal: J Am Soc Echocardiogr Date: 2013-09 Impact factor: 5.251
Authors: Arturo Evangelista; Frank Flachskampf; Patrizio Lancellotti; Luigi Badano; Rio Aguilar; Mark Monaghan; José Zamorano; Petros Nihoyannopoulos Journal: Eur J Echocardiogr Date: 2008-07
Authors: Akshay Gupta; Andrew T Lawrence; Kousik Krishnan; Clifford J Kavinsky; Richard G Trohman Journal: Am Heart J Date: 2007-06 Impact factor: 4.749
Authors: Jhanelle E Gray; Augusto Villegas; Davey Daniel; David Vicente; Shuji Murakami; Rina Hui; Takayasu Kurata; Alberto Chiappori; Ki Hyeong Lee; Byoung Chul Cho; David Planchard; Luis Paz-Ares; Corinne Faivre-Finn; Johan F Vansteenkiste; David R Spigel; Catherine Wadsworth; Maria Taboada; Phillip A Dennis; Mustafa Özgüroğlu; Scott J Antonia Journal: J Thorac Oncol Date: 2019-10-14 Impact factor: 15.609