ArticleRadiation oncology (London, England)2024
Dose to cardiac substructures and cardiovascular events in esophageal cancer patients treated with definitive radiotherapy.
Article in Radiation oncology (London, England), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Radiotherapy-Induced Side Effects: Epidemiology, Pathogenesis, Prevention and Treatments.MedComm · 2026Review
- Impact of Chronic Kidney Disease Stages 3-5 on Mortality and Morbidity Outcomes in Patients with Esophageal Cancer: A Propensity-Score-Matched Cohort Study.Current oncology (Toronto, Ont.) · 2026Article
- Cardiovascular and cerebrovascular related death among patients with esophageal cancer: an international multicenter study.Journal of thoracic disease · 2026Article
- Benefits of daily online plan adaptation with reduced margins in neoadjuvant chemoradiotherapy for esophageal cancer.Physics and imaging in radiation oncology · 2026Article
- Radiation-induced cardiac substructure damage and dose constraints: a review.Radiation oncology (London, England) · 2025Review
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Authors and funding
8 authors.
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Abstract
introductionWhile there is a growing amount of data on the cardiac toxicity of radiotherapy (RT) in relation to its impact on cardiac sub-structures (CSS), there are only few studies addressing this issue in patients followed for esophageal cancer (ESOC). We aimed to evaluate the association between independent parameters of dose received by CSS and major cardiac events (MACEs) in this population. MATERIALS AND
methodsWe retrospectively analyzed 122 patients treated with exclusive RT or chemo-RT for ESOC. Heart and CSS i.e. right atrium, left atrium (LA), right ventricle, left ventricle and myocardium, have been automatically segmented, and dose volume histogram were extracted. Cardiac events were collected focusing on the occurrence of MACEs of grade 3 or higher (G3+) and grade 4 or higher (G4+) according to the CTCAE v5.0.
resultsWith a median follow-up of 21.9 months and in a population of high to very high cardiovascular risk (95.5%), 21 (17.2%) and 9 (7.4%) patients had G3 + and G4 + MACEs with a respective median time to event of 13.05 and 9.8 months. After multivariate analysis and among all heart and CSS-based dosimetric features, only the volume of LA receiving 15 Gy or more (V15LA) remained significantly associated with the G3 + and G4 + MACEs. The use of volumetric modulated arctherapy significantly reduced V15LA compared with 3D conformal RT.
conclusionIn a cohort of ESOC patients treated with exclusive RT, incidence of MACEs was associated with V15LA, underlining the importance of CSS. These high cardiovascular (CV) risk patients should benefit from standard CV assessment and strict control of their risk factors.
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