Abstract
Purpose: Cardiotoxicities induced by cancer therapy can negatively affect quality of life and survival. We investigated whether high-sensitivity cardiac troponin T (hs-cTnT) levels could serve as biomarker for early detection of cardiac adverse events (CAEs) after chemoradiation therapy (CRT) for non-small cell lung cancer (NSCLC). Methods and Materials: This study included 225 patients who received concurrent platinum and taxane-doublet chemotherapy with thoracic radiation therapy to a total dose of 60 to 74 Gy for NSCLC. All patients were evaluated for CAEs; 190 patients also had serial hs-cTnT measurements. Results: Grade ≥3 CAEs occurred in 24 patients (11%) at a median interval of 9 months after CRT. Pretreatment hs-cTnT levels were higher in men, in patients aged ≥64 years, and in patients with pre-existing heart disease or poor performance status (P <.05). hs-cTnT levels increased at 4 weeks during CRT (P <.05) and decreased after completion of CRT but did not return to pretreatment levels (P =.002). The change (Δ) in hs-cTnT levels during CRT correlated with mean heart dose (P =.0004), the heart volumes receiving 5 to 55 Gy (P <.05), and tumor location (P =.006). Risks of severe CAEs and mortality were significantly increased if the pretreatment hs-cTnT was >10 ng/L or the Δ during CRT was ≥5 ng/L. Conclusions: Elevation of hs-cTnT during CRT was radiation heart dose-dependent, and high hs-cTnT levels during the course of CRT were associated with CAEs and mortality. Routine monitoring of hs-cTnT could identify patients who are at high risk of CRT-induced CAEs early to guide modifications of cancer therapy and possible interventions to mitigate cardiotoxicity.
Original language | English (US) |
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Pages (from-to) | 907-916 |
Number of pages | 10 |
Journal | International Journal of Radiation Oncology Biology Physics |
Volume | 111 |
Issue number | 4 |
DOIs | |
State | Published - Nov 15 2021 |
ASJC Scopus subject areas
- Radiation
- Oncology
- Radiology Nuclear Medicine and imaging
- Cancer Research
MD Anderson CCSG core facilities
- Biostatistics Resource Group