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作者

Guoxin Cai, Chuanbao Li, Jisheng Li, Jianmin Yang, Chengming Li, Liangchao Sun, Jianing Li, Jinming Yu, Xue Meng

作者单位

Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China. ² Department of Emergency, Chest Pain Center, Qilu Hospital of Shandong University, Jinan, China Affiliations ¹ Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China. Electronic address: mengxue5409@16 Department of Cardiovascular Medicine, Qilu Hospital of Shandong University, Jinan, Shandong, China. ³ Department of Medical Oncology, Cancer Center, Qilu Hospital of Shandong University, Jinan, Shandong, China. ⁴ Department of Cardiovascular Medicine, Qilu Hospital of Shandong University, Jinan, Shandong, China. ⁵ Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China. ⁶ Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China com.

刊名

International journal of radiation oncology, biology, physics

年份

2022

ISSN

1879-355X

关键词

Cardiac events Cardiac substructure dosimetric parameters Esophageal cancer Overall survival Predictive modeling.

摘要

Purpose: To investigate the predictive value of the cardiac substructures dosimetric parameters for cardiac toxicity after definitive radiotherapy in locally advanced esophageal cancer. Methods and materials: Between August 2010 and January 2016, 716 patients with stage II-III esophageal cancer receiving definitive radiotherapy at two institutions were divided into the training and external validation cohorts . Dose-volume histogram parameters for the whole heart and CSs were extracted. Compe...更多

Purpose: To investigate the predictive value of the cardiac substructures dosimetric parameters for cardiac toxicity after definitive radiotherapy in locally advanced esophageal cancer. Methods and materials: Between August 2010 and January 2016, 716 patients with stage II-III esophageal cancer receiving definitive radiotherapy at two institutions were divided into the training and external validation cohorts . Dose-volume histogram parameters for the whole heart and CSs were extracted. Competing risks and Cox regressions analyses were performed. The predictive performance of the models was evaluated using the area under the receiver operating characteristic curve and Brier score. Results: With a median follow-up of 93 months, 68 patients developed grade ≥ 3 cardiac events , at a median of 13.5 months to first event. Multivariable analysis showed left ventricle , left anterior descending , and mean left circumflex variables were significantly associated with G3+ CEs. The AUCs and Brier scores demonstrated favorable predictive accuracies of the models integrating these CS variables when predicting G3+ CEs in the training and validation cohorts. However, compared to the WH variables, the CS variables did not significantly improve the prediction of G3+ CEs. Nevertheless, when G3+ acute coronary syndrome/congestive heart failure CE was the outcome of interest, models based on the LAD or LCX variables were superior to the WH variable models in training and validation cohorts. Conclusions: Models based on CSs variables showed favorable predictive accuracy for G3+ CEs. The LAD and LCX variables significantly improved the prediction of G3+ ACS/CHF events compared to the WH variables. Radiation doses to CSs, such as LCX and LAD, should be monitored to help reduce the occurrence of significant CEs in patients with esophageal cancer undergoing definitive radiotherapy.收起

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