SynthesisInternational journal of radiation oncology, biology, physics2019
Is the Importance of Heart Dose Overstated in the Treatment of Non-Small Cell Lung Cancer? A Systematic Review of the Literature.
Synthesis in International journal of radiation oncology, biology, physics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
39 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A systematic review and meta-analysis of treatment-related toxicities of curative and palliative radiation therapy in non-small cell lung cancer.Scientific reports · 2021Pooled it
- Interpretable Machine Learning for Choosing Radiation Dose-volume Constraints on Cardio-pulmonary Substructures Associated with Overall Survival in NRG Oncology RTOG 0617.International journal of radiation oncology, biology, physics · 2023Trial
- Optimal combination of heart and lung dose parameters in radiotherapy for locally advanced non-small cell lung carcinoma: a multicenter retrospective study.Journal of radiation research · 2026Observational
- Radiotherapy and Cardiovascular Disease Survival Risk in Non-Small Cell Lung Cancer: A Population-Based Study From the Surveillance, Epidemiology, and End Results Database.Cancer medicine · 2026Article
- Radiation Doses to Cardiac Substructures Predict Elevation in High-sensitivity Cardiac Troponin T Levels in Radiation Therapy for Lung Cancer.International journal of radiation oncology, biology, physics · 2026Article
- Article
- Evaluating the impact of cardiac substructure dosimetric parameters on survival in lung cancer patients undergoing postoperative radiotherapy.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2025Article
- Cardiotoxicity following thoracic radiotherapy for lung cancer.British journal of cancer · 2025Review
- Dosimetric Planning Comparison for Left Ventricle Avoidance in Non-small Cell Lung Cancer Radiotherapy.Cureus · 2024Article
- Overview of cardiac toxicity from radiation therapy.Journal of medical imaging and radiation oncology · 2024Review
- Moving beyond mean heart dose: The importance of cardiac substructures in radiation therapy toxicity.Journal of medical imaging and radiation oncology · 2024Review
- Heart and Lung Dose as Predictors of Overall Survival in Patients With Locally Advanced Lung Cancer. A National Multicenter Study.JTO clinical and research reports · 2024Article
- Novel Functional Radiomics for Prediction of Cardiac Positron Emission Tomography Avidity in Lung Cancer Radiotherapy.JCO clinical cancer informatics · 2024Article
- Estimating how contouring differences affect normal tissue complication probability modelling.Physics and imaging in radiation oncology · 2024Article
- Cardiac radiation dose is associated with inferior survival but not cardiac events in patients with locally advanced non-small cell lung cancer in the era of immune checkpoint inhibitor consolidation.Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology · 2024Article
- Radiotherapy toxicity prediction using knowledge-constrained generalized linear model.IISE transactions on healthcare systems engineering · 2024Article
- Review
- Dosimetric analysis of 17 cardiac Sub-structures, Toxicity, and survival in ultra central lung tumor patients treated with SBRT.Clinical and translational radiation oncology · 2023Article
- Association between radiotherapy protocol variations and outcome in the CONVERT trial.Clinical and translational radiation oncology · 2023Article
- On the feasibility of cardiac substructure sparing in magnetic resonance imaging guided stereotactic lung radiotherapy.Medical physics · 2023Article
Corrections and comments
- Commented on by
- Commented on by
- Commented on by
- Commented on by
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeSome recent studies have suggested a relationship between cardiac dose and mortality in non-small cell lung cancer (NSCLC), but others have reported conflicting data. The goal of this study was to conduct a systematic review and meta-analysis to provide an evidence-based estimate of the relationship between cardiac dose and mortality in these patients. METHODS AND MATERIALS: A systematic review of MEDLINE (PubMed) and Embase databases (inception to January 2018) was performed according to PRISMA guidelines. Studies that evaluated cardiac dosimetric factors in patients with NSCLC and included outcomes of cardiac events, cardiac mortality, and/or overall survival were identified.
resultsFrom 5614 patients across 22 studies, a total of 214 cardiac dosimetric parameters (94 unique) were assessed as possible predictors of cardiac toxicity or death. Assessed predictors included general (eg, mean heart dose [MHD]), threshold-based (eg, heart V5), and anatomic-based (eg, atria, ventricles) dosimetric factors. The most commonly analyzed parameters were MHD, heart V5, and V30. Most studies did not make corrections for multiplicity of testing. For overall survival, V5 was found to be significant on multivariable analysis (MVA) in 1 of 11 studies and V30 in 2 of 12 studies; MHD was not significant in any of 8 studies. For cardiac events, V5 was found to be significant on multivariable analysis in 1 of 2 studies, V30 in 1 of 3 studies, and MHD in 2 of 4 studies. A meta-analysis of the data could not be performed because most negative studies did not report effect estimates.
conclusionsConsistent heart dose-volume parameters associated with overall survival of patients with NSCLC were not identified. Multiplicity of testing is a major issue and likely inflates the overall risk of type I errors in the literature. Future studies should specify predictors a priori, correct for multiplicity of testing, and report effect estimates for nonsignificant variables.
Indexed as
Identifiers
30630029What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.