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A. Schols

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    Poster Display session (Friday) (ID 65)

    • Event: ELCC 2018
    • Type: Poster Display session
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 4/13/2018, 12:30 - 13:00, Hall 1
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      124P - Cardiac events in stage III non-small cell lung cancer (NSCLC): An attention shift to cardio-oncology collaboration (ID 587)

      12:30 - 13:00  |  Author(s): A. Schols

      • Abstract
      • Slides

      Recently it was shown that 15% of stage III NSCLC patients, treated with thoracic radiotherapy in dose-escalated trials, suffer from late cardiac events.[1] However, the prevalence of pre-existent cardiac co-morbidity in daily clinical practice in these patients and the development of cardiac events during follow-up is still unclear. As these patients are treated with curative intent and have a five survival rate 25%, there is need for a study to investigate the development of cardiac events and the relation with pre-existent cardiac co-morbidity.

      In this retrospective cohort study a thorough patient file search was carried out in 153 patients diagnosed with stage III NSCLC, treated with (chemo-)radiotherapy between 2006 and 2011 in our center. Primary endpoint was the incidence of pre-existing cardiac comorbidity and relation with the development of serious cardiac events, defined as CTCAE 4.0 grade >2, within five years after a curative treatment with (chemo)radiotherapy. Cardiovascular risk prediction was calculated for each patient according to WHO/ISH, which indicates the 10-year risk of a serious cardiovascular event.

      Pre-existing cardiac comorbidity was seen in 46 patients (31.1%) with most frequently myocardial infarct/ coronary artery disease (9.8%) and arrhythmia (7.8%). WHO/ISH cardiovascular risk prediction was > 10% in 60.1% of the patients. Serious cardiac events appeared in 26% of the patients in the second year after treatment (20.3%). Most frequent cardiac events were arrhythmia (9.2%), myocardial infarction (6.5%), congestive heart failure (4.6%) and pericardial effusion (4.6%).Table:Serious cardiac events within subgroups of the study population

      Total N = 153Cardiac history N = 46No cardiac history N = 102WHO/ISH Cardiac event risk > 10% N = 78
      Cardiac events CTCAE-score > 2 (N/%)38 (26%)14 (30%)24 (23%)18 (23%)
      Missing (N)7---
      Median time to event 1–2 years (N/%)17 (11.6%)6 (13%)11 (10.8%)16 (20.5%)

      In daily clinical practice 1/3th of patients with stage III NSCLC, treated with (chemo-)radiotherapy, have pre-existing cardiac comorbidity. In addition, 26% develop a serious cardiac event during follow-up, even in patients without cardiac history. Therefor it is important to identify patients at risk in order to prevent these cardiac events.

      Clinical trial identification:

      Legal entity responsible for the study:
      Maastricht University Medical Center

      Has not received any funding

      D. De Ruysscher: Consulting or advisory role to disclose: Bristol-Myers Squibb I have research funding to disclose: Brsitol-Myers-Squibb (BMS). A-M. Dingemans: Reports other from Roche/Genentech, other from MSD Oncology, other from AstraZeneca, other from Pfizer, other from Lilly, other from Boehringer Ingelheim, other from Bristol-Myers Squibb, other from Clovis Oncology, outside the submitted work. All other authors have declared no conflicts of interest.

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