Radiotherapy that exposed the heart to high doses was associated with an increased risk of hospitalization, but not death, for cancer patients after a COVID-19 diagnosis, according to a study published in Radiotherapy & Oncology.

“To date, this is the largest study evaluating the impact of RT [radiotherapy] on outcomes in COVID-19 patients by specifically assessing the role of cardiopulmonary dose,” the study authors wrote.

The study included 350 patients with cancer who had received radiotherapy at Memorial Sloan Kettering Cancer Center in New York, New York, and were later diagnosed with COVID-19. There were 195 patients who had received cardiopulmonary radiotherapy.

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Cancer types included breast (33%), gastrointestinal (15%), genitourinary (15%), hematologic (11%), thoracic (10%), head and neck (8%), gynecological (3%), sarcoma (3%), and central nervous system (2%).

In all, 39% of patients were admitted to a hospital, 17% had life-threatening disease, and 14% died from COVID-19.

In a multivariate analysis, 3 variables were linked to an increased risk of hospitalization after a COVID-19 diagnosis — history of acute renal injury, shorter time between radiotherapy and COVID-19 diagnosis, and higher mean dose of radiation to the heart (P ≤.0038 for all).

None of these variables were linked to life-threatening COVID-19 or death in a multivariate analysis.

The study authors concluded that these data “suggest the need for close monitoring in patients with a history of recent thoracic radiation but do not support withholding RT in patients with cancer to reduce the risk for life-threatening COVID-19 outcomes.”

Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.


LaPlant Q, Thor M, Shaverdian N, et al. Association of prior radiation dose to the cardiopulmonary system with COVID-19 outcomes in patients with cancer. Radiother Oncol. Published online June 6, 2021. doi:10.1016/j.radonc.2021.06.002