Novel risk score for predicting acute cardiovascular and cerebrovascular events after chest radiotherapy in patients with breast or lung cancer

The risk for major acute cardiovascular and cerebrovascular events after RT for breast and lung cancer can be stratified by simple, easy to use and effective tools, even before chest radiation. This information can be used for shared decision making and treatment planning, as well as incentivizing optimal cardiovascular risk factor and disease management. Post-therapy model (C2AD2) included CAC (2 points), MACCE history (2 points), age >= 74 (3 points), DM (2 points), and mean heart radiation dose >= 850 mGy (2 points), and pre-therapy model (C2AD) included post-therapy model parameters minus mean heart radiation dose. Both models stratified into three risk groups: low (0-2), intermediate (3-5), and high (>= 6).Post-RT MACCE occurred in 6.1 and 5.6% in the derivation and validation cohort over a mean follow-up of 42 +/- 13 months.Post-RT MACCE across these groups were 2.7, 8.9, and 19.8% in the derivation, and 3.9, 6.6, and 16.4% in the validation cohort for post-therapy model (C2AD2) and 2.8, 9.2, and 20.4% in the derivation and 3.7, 9.2, and 13.2% in the validation cohort for pre-therapy model. Both models showed statistically significant graded survival outcome.