ArticleActa oncologica (Stockholm, Sweden)2026
The Association of right atrium and sinoatrial node irradiation with atrial fibrillation and radiation-induced heart disease in non-small cell lung cancer.
Article in Acta oncologica (Stockholm, Sweden), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Associations between reported atrial fibrillation burden and cardiac substructure dosimetric variables in patients receiving thoracic radiotherapy for malignancies involving the thorax: a systematic review and meta-analysis.Frontiers in oncology · 2026Pooled it
- Incidence of new-onset atrial fibrillation after thoracic radiotherapy in non-small cell lung cancer: a systematic review and meta-analysis.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026Review
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8 authors.
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No grant is acknowledged in the PubMed record.
Abstract
background and purposeRadiotherapy (RT) is a key treatment for locally advanced non-small cell lung cancer (NSCLC). Tumours near the heart may result in unintended cardiac radiation exposure, increasing the risk of cardiotoxicity, such as de novo atrial fibrillation (DNAF) and de novo heart diseases (DNHD) as ischemic heart disease, heart failure, arterial hypertension or sudden cardiac death. This study investigated associations between radiation dose to cardiac substructures and risk of DNAF and DNHD. Patient/material and methods: This retrospective cohort study included patients treated between January 1, 2010, and December 31, 2020 for NSCLC with definitive RT. The heart, right atrium (RA) and sinoatrial node (SAN) were delineated. Associations between dose-volume parameters and cardiac outcomes were analysed using multivariable models adjusted for relevant confounders. Kaplan-Meier curves estimated survival; p-values < 0.05 were significant.
resultsAmong 273 included patients, 9.5% had AF pre-RT and 12.8% developed DNAF. DNAF was significantly associated with SAN Dmax (hazard ratio [HR] = 1.01), RA Dmax (HR = 1.02), RA Dmean (HR = 1.03), mean heart dose (MHD) (HR = 1.04) and heart V40Gy (HR = 1.03). One-year probabilities of DNAF and DNHD were 9.3% and 11%, increasing to 12.2% and 13.2% at 2 years. DNHD was significantly associated with SAN Dmax (HR = 1.02), RA Dmax (HR = 1.02), RA Dmean (HR = 1.04), MHD (HR = 1.06), heart V25Gy (HR = 1.03) and V40Gy (HR = 1.03).
interpretationThe RA and SAN may be considered organs at risk in future RT planning. Minimising cardiac radiation is important to reduce DNAF and DNHD risk. Validation in an independent cohort is warranted.
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