ArticleRadiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology2020
The impact of baseline shifts towards the heart after image guidance on survival in lung SABR patients.
Article in Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- 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
- Optimizing Dose Reduction to the Left Anterior Descending Artery in Patients With Locally Advanced Lung Cancer Treated With Definitive Radiation Therapy: A Feasibility Study of Coplanar Treatments Using Double-Stacked Multileaf Collimator.Advances in radiation oncology · 2025Article
- A noninvasive realtime body position monitoring system for the entire course of tumor radiotherapy.NPJ digital medicine · 2025Article
- Moving beyond mean heart dose: The importance of cardiac substructures in radiation therapy toxicity.Journal of medical imaging and radiation oncology · 2024Review
- 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
- Dual effect of radiotherapy related concomitant cardiovascular diseases in non-small cell lung cancer.Cancer medicine · 2023Review
- Role of Real-World Data in Assessing Cardiac Toxicity After Lung Cancer Radiotherapy.Frontiers in oncology · 2022Review
- Cardiac Toxicity of Thoracic Radiotherapy: Existing Evidence and Future Directions.Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer · 2021Review
- Initial Clinical Experience of MR-Guided Radiotherapy for Non-Small Cell Lung Cancer.Frontiers in oncology · 2021Article
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5 authors.
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Abstract
background and purposeA recent study of NSCLC patients showed small residual shifts of the high dose region towards/away from the heart after image-guidance were significantly related to overall survival. This study investigates whether the effect is observed in a SABR cohort, who have significantly different baseline outlook and are treated using an imaging protocol matching on the tumour rather than bony-anatomy alone. MATERIALS AND
methods136 NSCLC patients treated with SABR were studied. The mean baseline shift of the tumour in the direction of the heart over the course of treatment was determined for each patient and used to categorise patients into risk groups. Kaplan-Meier survival curves were plotted and multivariable analysis performed to assess significance of the vector shift to the heart alongside common clinical variables.
resultsThe vector shift to the heart was independent of all tested clinical variables. A significant difference was seen in patient survival, with patients with shifts towards the heart having significantly worse prognosis as compared to patients with shifts away. Multivariable analysis found a hazard ratio of 1.262 per mm (p = 0.013) for the vector shift to the heart, i.e. for every 1 mm shift of the high dose region towards the heart there is a 1.262 higher chance of death.
conclusionsBaseline shifts towards the heart significantly correlate with overall survival in a cohort of NSCLC SABR patients, with increased risk with increasing shifts towards the heart. These results provide further evidence for the use of stricter heart dose planning constraints for thoracic radiotherapy and suggest a heart planning organ at risk volume may be required for SABR treatments to account for baseline shifts.
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