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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Cardiac mortality in limited-stage small cell lung cancer
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Cardiac mortality in limited-stage small cell lung cancer

机译：有限阶段小细胞肺癌的心脏病死亡率

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IntroductionLife expectancy of patients with limited-stage small cell lung cancer (LS-SCLC) continues to rise; thus, characterization of long-term toxicities is essential. Although there are emerging data linking cardiac irradiation doses with survival for non-small cell lung cancer, there are currently minimal data on cardiac-specific mortality (CSM) in LS-SCLC. The goal of this investigation was to evaluate CSM between left- and right-sided cases. MethodsThe Surveillance, Epidemiology, and End Results database was queried for stage I–III primary SCLC patients receiving radiotherapy; CSM was compared between left- and right-sided diseases. Accounting for mortality from other causes, Gray’s test compared cumulative incidences of CSM between both groups. Multiple multivariate models examined the independent effect of laterality on CSM, including the Fine and Gray competing risk model and the Cox proportional hazards model. ResultsOf 19,692 patients, 7991 (41%) were left-sided and 11,701 (59%) were right-sided. Left-sided patients experienced significantly higher CSM overall (3.3% vs. 2.6%,p?=?0.004). Laterality was an independent predictor of CSM in the overall population in the Fine and Gray competing risk model (p?=?0.006) as well as the Cox proportional hazards model (p?=?0.007). The overall hazard ratio for CSM by disease laterality was 1.27 (95% confidence interval, 1.08–1.50). Laterality had no statistical association with non-cardiac mortality in the Fine and Gray competing risk model (p?=?0.130). ConclusionsAlthough causation between radiotherapy and CSM in LS-SCLC cannot be stated based on these data, we encourage clinical attentiveness to cardiac-sparing radiotherapy for LS-SCLC, along with further investigation evaluating dosimetric correlates for cardiotoxicity.
机译：介绍阶段小细胞肺癌（LS-SCLC）患者的预期寿命继续上升;因此，长期毒性的表征至关重要。虽然存在与非小细胞肺癌生存的心脏辐射剂量的新兴数据，但目前LS-SCLC中的心脏特异性死亡率（CSM）存在最小的数据。这项调查的目标是评估左侧和右侧案件之间的CSM。验证了接受放射治疗的I-III初级SCLC患者的I-III初级SCLC患者查询监视，流行病学和最终结果数据库;在左侧和右侧疾病之间比较了CSM。从其他原因中占死亡率，灰色的测试比较了两组CSM的累积累积。多变量模型检测了CSM横向性的独立效应，包括细小竞争风险模型和COX比例危险模型。结果19,692名患者，7991名（41％）左侧，11,701（59％）右侧。左侧患者的CSM患者总体显着高（3.3％vs.2.6％，P？= 0.004）。横向性是精细和灰色竞争风险模型的整体人群中CSM的独立预测因子（P？= 0.006）以及Cox比例危险模型（P？= 0.007）。疾病横向性CSM的整体危险比为1.27（95％置信区间，1.08-1.50）。肤色在细小和灰色竞争风险模型中没有与非心脏病死亡率的统计关联（P？= 0.130）。结论虽然LS-SCLC中的放射疗法和CSM之间的因子不予陈述，但我们鼓励对LS-SCLC的心脏保留放射治疗的临床关节，以及进一步调查对心脏毒性相关的剂量相关性。

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