Radiation Therapy Increases 5-year Rate of Cardiac Events in Small-cell Lung Cancer
Researchers analyzed the outcomes of 7060 patients with SCLC from the SEER database to determine the rates of new CEs among patients treated with chemotherapy plus RT or chemotherapy alone.
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Radiation therapy (RT) is correlated with an absolute increased risk of approximately 5% in the rate of cardiac events (CE) at 5 years after treatment for small-cell lung cancer, according to an oral abstract presented at the International Association for the Study of Lung Cancer (IASLC) 18th Annual World Conference on Lung Cancer (WCLC) in Yokohama, Japan.1
Previous studies demonstrated that doses of RT to the heart may lead to inferior overall survival (OS) rates in patients with non–small cell lung cancer, but the cardiovascular effect RT may have in patients with SCLC has not been fully explored.
For this study, researchers collected and analyzed the outcomes of 7060 patients with limited-stage or extensive-stage SCLC from the Surveillance, Epidemiology, and End Results (SEER) database and Medicare claims data to determine the rates of new CEs among patients treated with chemotherapy plus RT or chemotherapy alone.
Patients who received chemotherapy plus RT had an improved overall survival rate compared with patients who received chemotherapy alone (P < .001), with 1-year OS rates of 35.0% and 21.4%, respectively. OS rates were also superior for the chemotherapy plus RT arm compared with the chemotherapy alone arm at 5-years (6.6% vs 2.3%).
RT was associated with CE (P = .008), with a cumulative incidence of 36.4% for the chemotherapy plus RT arm vs 35.4% for the chemotherapy alone arm at 1 year, and 44.1% vs 39.0% at 5 years, respectively.
Patients with extensive-stage SCLC (P < .001), who were Afro-Caribbean (P < .001), and who had higher Charlson-Deyo scores (P = .001) had a higher hazard ratio of CE.
The authors concluded that “[f]urther evaluation of cardiac sparing radiation techniques should be evaluated for patients with SCLC.”
Read more of Cancer Therapy Advisor's coverage of the IASLC 18th World Conference on Lung Cancer (WCLC) by visiting the conference page.
- Ferris MJ, Jiang R, Ward K, Ramalingam SS, Behera M, Higgins KA. Radiation therapy is associated with an increased incidence of cardiac events in small cell lung cancer patients. Presented at: International Association for the Study of Lung Cancer 18th World Conference on Lung Cancer; Yokohama, Japan: October 15-18, 2017. Abstract OA 01.06.