Document Detail


Symptomatic cardiac toxicity is predicted by dosimetric and patient factors rather than changes in 18F-FDG PET determination of myocardial activity after chemoradiotherapy for esophageal cancer.
MedLine Citation:
PMID:  22682539     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To determine factors associated with symptomatic cardiac toxicity in patients with esophageal cancer treated with chemoradiotherapy.
MATERIAL AND METHODS: We retrospectively evaluated 102 patients treated with chemoradiotherapy for locally advanced esophageal cancer. Our primary endpoint was symptomatic cardiac toxicity. Radiation dosimetry, patient demographic factors, and myocardial changes seen on (18)F-FDG PET were correlated with subsequent cardiac toxicity. Cardiac toxicity measured by RTOG and CTCAE v3.0 criteria was identified by chart review.
RESULTS: During the follow up period, 12 patients were identified with treatment related cardiac toxicity, 6 of which were symptomatic. The mean heart V20 (79.7% vs. 67.2%, p=0.05), V30 (75.8% vs. 61.9%, p=0.04), and V40 (69.2% vs. 53.8%, p=0.03) were significantly higher in patients with symptomatic cardiac toxicity than those without. We found the threshold for symptomatic cardiac toxicity to be a V20, V30 and V40 above 70%, 65% and 60%, respectively. There was no correlation between change myocardial SUV on PET and cardiac toxicity, however, a greater proportion of women suffered symptomatic cardiac toxicity compared to men (p=0.005).
CONCLUSIONS: A correlation did not exist between percent change in myocardial SUV and cardiac toxicity. Patients with symptomatic cardiac toxicity received significantly greater mean V20, 30 and 40 values to the heart compared to asymptomatic patients. These data need validation in a larger independent data set.
Authors:
Andre Konski; Tianyu Li; Michael Christensen; Jonathan D Cheng; Jian Q Yu; Kevin Crawford; Oleh Haluszka; Jeffrey Tokar; Walter Scott; Neal J Meropol; Steven J Cohen; Alan Maurer; Gary M Freedman
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Publication Detail:
Type:  Journal Article     Date:  2012-06-07
Journal Detail:
Title:  Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology     Volume:  104     ISSN:  1879-0887     ISO Abbreviation:  Radiother Oncol     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-07-03     Completed Date:  2012-11-07     Revised Date:  2013-07-12    
Medline Journal Info:
Nlm Unique ID:  8407192     Medline TA:  Radiother Oncol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  72-7     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Department of Radiation Oncology, Wayne State University School of Medicine, Detroit, MI 48201, USA. akonski@med.wayne.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Chemoradiotherapy*
Esophageal Neoplasms / therapy*
Female
Fluorodeoxyglucose F18 / diagnostic use*
Heart / drug effects,  radiation effects,  radionuclide imaging*
Humans
Male
Middle Aged
Positron-Emission Tomography
Radiopharmaceuticals / diagnostic use*
Radiotherapy Dosage
Retrospective Studies
Grant Support
ID/Acronym/Agency:
P30 CA006927/CA/NCI NIH HHS
Chemical
Reg. No./Substance:
0/Radiopharmaceuticals; 63503-12-8/Fluorodeoxyglucose F18
Comments/Corrections

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