Assessment of Prognostic Value of High- Sensitivity Cardiac Troponin T for Early Prediction of Chemoradiation Therapy-Induced Cardiotoxicity in Patients with Non-Small Cell Lung Cancer: A Secondary Analysis of a Prospective Randomized Trial

被引:18
作者
Xu, Ting [1 ]
Meng, Qing H. [2 ]
Gilchrist, Susan C. [3 ]
Lin, Steven H. [1 ]
Lin, Ruitao [4 ]
Xu, Tianlin [5 ]
Milgrom, Sarah A. [6 ]
Gandhi, Saumil J. [1 ]
Wu, Haijun [7 ]
Zhao, Yu [8 ]
Lopez-Mattei, Juan C. [9 ]
Mohan, Radhe [10 ]
Liao, Zhongxing [1 ]
机构
[1] Univ Texas MD Anderson Canc Ctr, Dept Radiat Oncol, Houston, TX 77030 USA
[2] Univ Texas MD Anderson Canc Ctr, Dept Lab Med, Houston, TX USA
[3] Univ Texas MD Anderson Canc Ctr, Dept Clin Canc Prevent & Cardiol, Houston, TX USA
[4] Univ Texas MD Anderson Canc Ctr, Dept Biostat, Houston, TX USA
[5] Univ Texas Hlth Sci Ctr Houston, Sch Publ Hlth, Dept Biostat & Data Sci, Houston, TX USA
[6] Univ Colorado, Dept Radiat Oncol, Denver, CO USA
[7] Cent South Univ, Xiangya Hosp, Dept Radiat Oncol, Xiangya Med Sch, Changsha, Hunan, Peoples R China
[8] Univ Hosp, Dept Med, New York, NY USA
[9] Univ Texas MD Anderson Canc Ctr, Dept Cardiol, Houston, TX USA
[10] Univ Texas MD Anderson Canc Ctr, Dept Radiat Phys, Houston, TX USA
来源
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS | 2021年 / 111卷 / 04期
基金
美国国家卫生研究院;
关键词
BREAST-CANCER; HEART-DISEASE; MYOCARDIAL-INFARCTION; BIOMARKERS; RADIOTHERAPY; CHEMOTHERAPY; MORTALITY; SURVIVAL; PREVENTION; TOXICITY;
D O I
10.1016/j.ijrobp.2021.07.035
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
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 (D) 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 D 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. (C) 2021 The Authors. Published by Elsevier Inc.
引用
收藏
页码:907 / 916
页数:10
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