Cardiac toxicity in association with chemotherapy and radiation therapy in a large cohort of older patients with non-small-cell lung cancer

被引:86
作者
Hardy, D. [1 ]
Liu, C. -C. [1 ]
Cormier, J. N. [2 ]
Xia, R. [1 ]
Du, X. L. [1 ,3 ]
机构
[1] Univ Texas Sch Publ Hlth, Dept Epidemiol, Div Epidemiol & Dis Control, Houston, TX 77030 USA
[2] Univ Texas MD Anderson Canc Ctr, Dept Surg Oncol, Houston, TX 77030 USA
[3] Univ Texas Sch Publ Hlth, Ctr Hlth Serv Res, Dept Epidemiol, Houston, TX 77030 USA
基金
美国医疗保健研究与质量局;
关键词
cardiac disorders; chemotherapy; lung cancer; radiation therapy; toxicity; ARTERY; RADIOTHERAPY; GEMCITABINE; CARBOPLATIN; COMBINATION; MEDICARE;
D O I
10.1093/annonc/mdq042
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: The study's objective was to investigate the risks of developing cardiac disorders following the administration of chemotherapy and radiation therapy in patients with non-small-cell lung cancer (NSCLC). Methods: The study consisted of 34 209 patients aged >= 65 years with American Joint Committee on Cancer stages I-IV NSCLC identified from the Surveillance, Epidemiology, and End Result-Medicare linked database (1991-2002) who were free of cardiac disorders at NSCLC diagnosis. Results: There were significant associations between the use of chemotherapy/radiation and the risks of developing ischemic heart disease, conduction disorders, cardiac dysfunction, and heart failure. The absolute risks for cardiac dysfunction increased with the administration of chemotherapy-only and radiation-only, and incrementally with chemoradiation. Men, blacks, older patients, those with higher comorbidity scores, and advanced disease were at higher risk. The risk for ischemic heart disease increased when radiation/chemoradiation were rendered to the left lung and both lungs and for cardiac dysfunction, radiation administered to the left lung. Conclusions: There were significant associations especially for cardiac dysfunction with use of chemotherapy/radiation therapy and risks of developing cardiac toxicity in NSCLC patients. The risks of treatment-associated cardiac toxicity, specifically ischemic heart disease and cardiac dysfunction, were greatest among those with left-sided lung tumors.
引用
收藏
页码:1825 / 1833
页数:9
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