The impact of right ventricular function on prognosis in patients with stage III non-small cell lung cancer after concurrent chemoradiotherapy.
Int J Cardiovasc Imaging
; 35(6): 1009-1017, 2019 Jun.
Article
en En
| MEDLINE
| ID: mdl-30941563
ABSTRACT
Right ventricular (RV) impairment after cancer therapy-related cardiotoxicity and its prognostic implications in lung cancer have not been examined. The present research sought to evaluate RV structure, function, and mechanics in stage III non-small-cell lung cancer (NSCLC) before and after concurrent chemoradiotherapy (CCRT), and to explore the associations between RV impairments, radiation dose, and all-cause mortality. This prospective investigation included 128 inoperable NSCLC patients who were scheduled to receive CCRT. Echocardiographic examination and strain evaluation was performed at baseline and 6 months post-CCRT in all participants. Conventional RV dimensions revealed no significant changes post-CCRT. However, a reduction in RV free wall strain (RV-fwLS) was observed at 6 months post-CCRT (- 28.3 ± 4.6% vs. - 25.5 ± 4.8%, P < 0.001). The same was revealed for global RV longitudinal strain (RV-GLS) (- 23.4 ± 2.9% vs. - 20.2 ± 3.4%, P < 0.001). Pearson correlation showed that RV radiation mean dose was related with the percentage change in RV-fwLS (r = 0.303, P = 0.001) and RV-GLS (r = 0.284, P = 0.002). In multivariable analysis, the percentage change in RV-fwLS was an independent predictor of all-cause mortality (HR 1.296, 95% CI 1.202-1.428, P < 0.001). RV longitudinal strain is deteriorated at 6 months post-CCRT. The RV mechanics deterioration was associated with radiation dose and affected the long-term outcome of stage III NSCLC patients treated with CCRT.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Traumatismos por Radiación
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Dosificación Radioterapéutica
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Función Ventricular Derecha
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Carcinoma de Pulmón de Células no Pequeñas
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Disfunción Ventricular Derecha
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Quimioradioterapia
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Neoplasias Pulmonares
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Contracción Miocárdica
Tipo de estudio:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Adolescent
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Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Int J Cardiovasc Imaging
Asunto de la revista:
DIAGNOSTICO POR IMAGEM
Año:
2019
Tipo del documento:
Article
País de afiliación:
China