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Heart Dose Is an Independent Dosimetric Predictor of Overall Survival in Locally
Advanced Non-Small Cell Lung Cancer.
Speirs C, Bradley J, et al . J Thorac Oncol. 2017 Feb;12(2):293-301
RTPG 0617: 416 patients with Clinical Data, 322 patients analyzed for toxicity and dosimetry
data. Multivariate analysis on 251 patient .
Factors independently associated with worse Overall Survival:
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Increasing heart V50 (volume receiving ≥50 Gy),
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Heart volume,
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Lung V5 (lung structure [excluding the target volume]) receiving > 5 Gy),
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bilateral mediastinal lymph node involvement,
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lack of concurrent chemotherapy
Heart V50 < 25% versus > 25%
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1-year OS rates 70.2% versus 46.8%
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2-year OS rates 45.9% versus 26.7% (p < 0.0001).
Median heart V50 was significantly higher (20.8% versus 13.9%, p < 0.0001) for
patients with any cardiac toxicity
CONCLUSIONS:
Heart dose is associated with OS and cardiac toxicity for patients with LA NSCLC
treated with chemoradiotherapy.