MedicalResearch.com Interview with:
Raymond H Mak, MD
Assistant Professor of Radiation Oncology
Harvard Medical School
Brigham and Women’s Hospital
Katelyn M. Atkins MD PhD
Harvard Radiation Oncology Program
Dana-Farber Cancer Institute
Brigham and Women’s Hospital
MedicalResearch.com: What is the background for this study? What are the main findings?
- Lung cancer remains the leading cause of cancer-related death worldwide and nearly half of patients will require radiation therapy as part of their care.
- Cardiac toxicity following radiotherapy has been well-studied in breast cancer and lymphomas, however the impact of cardiac toxicity following lung cancer radiotherapy has historically been under-appreciated due to the high risk of lung cancer death.
- Recent studies highlighting cardiac toxicity following lung cancer radiotherapy have been limited by small numbers of patients and, to our best knowledge, have not included validated cardiac event endpoints defined by the American Heart Association (AHA)/American College of Cardiology (ACC).
MedicalResearch.com: What did you do to solve this problem in oncology?
- We aimed to determine whether cardiac radiation dose exposure was associated with an increased risk of Major Adverse Cardiac Events (MACE), as defined by the AHA/ACC, and mortality.
- We performed this comprehensive analysis using one of the largest cohorts of locally-advanced lung cancer patients.
MedicalResearch.com: What are the main findings?
- We found that despite a high competing risk of death from lung cancer, cardiac radiation dose exposure is a modifiable cardiac risk factor for Major Adverse Cardiac Events and mortality.
- In particular, patients without pre-existing heart disease had a significantly higher risk of Major Adverse Cardiac Events and mortality when they received higher cardiac radiation doses (≥10 Gy) versus lower cardiac radiation doses (<10 Gy).
- These findings support a shared framework between radiation oncologists, primary care physicians, and cardiologists to identify high-risk patients and inform postradiotherapy cardiac risk prevention strategies.
MedicalResearch.com: What should readers take away from your report?
Response: Patients with lung cancer may benefit from more careful avoidance of high cardiac radiation dose exposure, preventive postradiotherapy cardiac care, and earlier recognition and treatment of cardiovascular events.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Prospective studies are needed to assess the effect of combined cardiac risk stratification, cardiac radiation dose reduction techniques, and postradiotherapy preventive care on survival and quality of life in patients with lung cancer.
MedicalResearch.com: Is there anything else you would like to add?
Response: The work represents a multi-disciplinary collaboration between radiation oncologists and cardiologists at Dana-Farber Cancer Institute, Brigham and Women’s Hospital, and Massachusetts General Hospital.
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