Please use this identifier to cite or link to this item: https://doi.org/10.1097/MD.0000000000017020
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
Authors: 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 
Keywords: Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
myocardial infarct
non-small cell lung cancer
post-operative thoracic radiotherapy
radiation dosimetry
ADJUVANT CHEMOTHERAPY
RADIATION-THERAPY
CARDIAC TOXICITY
ESCALATION TRIALS
STAGE-II
IMPACT
EPIDEMIOLOGY
SURVEILLANCE
DISEASE
Issue Date: 1-Aug-2019
Publisher: LIPPINCOTT WILLIAMS & WILKINS
Citation: 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 (2019-08-01). 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. MEDICINE 98 (35). ScholarBank@NUS Repository. https://doi.org/10.1097/MD.0000000000017020
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.
Source Title: MEDICINE
URI: https://scholarbank.nus.edu.sg/handle/10635/229757
ISSN: 00257974
15365964
DOI: 10.1097/MD.0000000000017020
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