Association of cardiac calcium burden with overall survival after radiotherapy for non-small cell lung cancer Journal Article
| Authors: | Haseltine, J. M.; Apte, A.; Jackson, A.; Yorke, E.; Yu, A. F.; Plodkowski, A.; Wu, A.; Peleg, A.; Al-Sadawi, M.; Iocolano, M.; Gelblum, D.; Shaverdian, N.; Simone, C. B. 2nd; Rimner, A.; Gomez, D. R.; Shepherd, A. F.; Thor, M. |
| Article Title: | Association of cardiac calcium burden with overall survival after radiotherapy for non-small cell lung cancer |
| Abstract: | Background and purpose: Coronary calcifications are associated with coronary artery disease in patients undergoing radiotherapy (RT) for non-small cell lung cancer (NSCLC). We quantified calcifications in the coronary arteries and aorta and investigated their relationship with overall survival (OS) in patients treated with definitive RT (Def-RT) or post-operative RT (PORT). Materials and methods: We analyzed 263 NSCLC patients treated from 2004 to 2017. Calcium burden was ascertained with a Hounsfield unit (HU) cutoff of > 130 in addition to a deep learning (DL) plaque estimator. The HU cutoff volumes were defined for coronary arteries (PlaqueCoro) and coronary arteries and aorta combined (PlaqueCoro+Ao), while the DL estimator ranged from 0 (no plaque) to 3 (high plaque). Patient and treatment characteristics were explored for association with OS. Results: The median PlaqueCoro and PlaqueCoro+Ao was 0.75 cm3 and 0.87 cm3 in the Def-RT group and 0.03 cm3 and 0.52 cm3 in the PORT group. The median DL estimator was 2 in both cohorts. In Def-RT, large PlaqueCoro (HR:1.11 (95%CI:1.04–1.19); p = 0.008), and PlaqueCoro+Ao (HR:1.06 (95%CI:1.02–1.11); p = 0.03), and poor Karnofsky Performance Status (HR: 0.97 (95%CI: 0.94–0.99); p = 0.03) were associated with worse OS. No relationship was identified between the plaque volumes and OS in PORT, or between the DL plaque estimator and OS in either Def-RT or PORT. Conclusions: Coronary artery calcification assessed from RT planning CT scans was significantly associated with OS in patients who underwent Def-RT for NSCLC. This HU thresholding method can be straightforwardly implemented such that the role of calcifications can be further explored. © 2023 The Authors |
| Keywords: | radiotherapy; non-small cell lung cancer; coronary calcifications |
| Journal Title: | Physics and Imaging in Radiation Oncology |
| Volume: | 25 |
| ISSN: | 2405-6316 |
| Publisher: | Elsevier B.V. |
| Date Published: | 2023-01-01 |
| Start Page: | 100410 |
| Language: | English |
| DOI: | 10.1016/j.phro.2023.01.001 |
| PROVIDER: | scopus |
| PMCID: | PMC9852638 |
| PUBMED: | 36687507 |
| DOI/URL: | |
| Notes: | Article -- MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PDF -- MSK corresponding authors are Annemarie Shepherd and Maria Thor -- Export Date: 1 February 2023 -- Source: Scopus |
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