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Konski A, Li TY, Christensen M, Cheng JD, Yu JQ, Crawford K, Haluszka O, Tokar J, Scott W, Meropol NJ, Cohen SJ, Maurer A, Freedman GM
Symptomatic cardiac toxicity is predicted by dosimetric and patient factors rather than changes in F-18-FDG PET determination of myocardial activity after chemoradiotherapy for esophageal cancer
Radiotherapy and Oncology (2012) 104:72-77.
Abstract
Purpose: To determine factors associated with symptomatic cardiac toxicity in patients with esophageal cancer treated with chemoradiotherapy. Material and methods: We retrospectively evaluated 102 patients treated with chemoradiotherapy for locally advanced esophageal cancer. Our primary endpoint was symptomatic cardiac toxicity. Radiation dosimetry, patient demographic factors, and myocardial changes seen on F-18-FDG PET were correlated with subsequent cardiac toxicity. Cardiac toxicity measured by RTOG and CTCAE v3.0 criteria was identified by chart review. Results: During the follow up period, 12 patients were identified with treatment related cardiac toxicity, 6 of which were symptomatic. The mean heart V20 (79.7% vs. 67.2%, p = 0.05), V30 (75.8% vs. 61.9%, p = 0.04), and V40 (69.2% vs. 53.8%, p = 0.03) were significantly higher in patients with symptomatic cardiac toxicity than those without. We found the threshold for symptomatic cardiac toxicity to be a V20, V30 and V40 above 70%, 65% and 60%, respectively. There was no correlation between change myocardial SUV on PET and cardiac toxicity, however, a greater proportion of women suffered symptomatic cardiac toxicity compared to men (p = 0.005). Conclusions: A correlation did not exist between percent change in myocardial SUV and cardiac toxicity. Patients with symptomatic cardiac toxicity received significantly greater mean V20, 30 and 40 values to the heart compared to asymptomatic patients. These data need validation in a larger independent data set. (C) 2012 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 104 (2012) 72-77
Note
Publication Date: 2012-07-01.
PMCID: PMC3389132
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