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Louise Murray

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    Mini Oral session III (ID 65)

    • Event: ELCC 2019
    • Type: Mini Oral session
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 4/12/2019, 17:45 - 18:45, Room C
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      72O - Multi-centre analysis of cardiac events following radical radiotherapy for lung cancer (ID 235)

      17:45 - 18:45  |  Author(s): Louise Murray

      • Abstract
      • Presentation
      • Slides


      Radical radiotherapy (RRT) plays an essential role in the management of early and locally advanced lung cancer. Recent studies suggest cardiac events post radiotherapy worsen survival outcome for patients. This study aims to identify risk factors which predispose patients to cardiac events post radiotherapy.

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      All patients who received RRT (including Stereotactic Body Radiotherapy (SBRT), radical fractionated radiotherapy and chemoradiotherapy) for lung cancer between 01/01/2010 to 30/12/2016 at 2 UK institutions have been included. Patients were excluded if they had multiple courses of radiotherapy to the chest. Individual patient clinical information has been retrieved from hospital electronic database. Patient and cancer demographics have been collected. Pre-existing cardiac conditions, Charlsons’ Co-morbidity index and Qrisk 3 scores were calculated. Post radiotherapy cardiac events were identified rom electronic patient records and time to cardiac events were calculated.

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      600 patients have been identified so far and processed. Median follow up is 31 months. Of all patients, 29% had pre-existing cardiac conditions. 52 patients experienced cardiac events following radiotherapy, of which 37% were ischaemic events. Of patients who experienced an ischaemic event, 58% did not have a known pre-existing cardiac condition. 71% of cardiac events post RRT occurred in the first 2 years following RT. Proportionally, patients who underwent radical fractionated radiotherapy and concurrent chemoradiotherapy had the highest incidence of cardiac events. Patient characteristics of those who experienced cardiac toxicity are summarized in the table below

      Total = 52 (10%)Ischaemic events19 (7 events lead to death – Grade 5)
      Pericardial(effusion) events8
      Arrhythmic events13
      Cardiac failure events12
      Pre-existing cardiac diagnosisPatients who had ischaemic events8/19 (4 previous MI, 2 IHD, 1 arrythmia and 1 valve abnormality
      Patients who had pericardial events1/8 (arrhythmia)
      Patients who had arrhythmic events6/13 (2 previous MI, 2 IHD, 1 CCF, 1 CCF and arrhythmia)
      Patients who had CCF events9/12 (2 previous MI, 5 IHD, 2 valvular abnormality)
      SexMale = 33 Female = 19
      AgeMedian = 73
      SmokingNever smoked0
      Ex-Smoker <10 PY0
      Ex-smoker <20 PY9
      Ex-Smoker 20-40PY15
      Ex-Smoker >40 PY9
      Current Smoker19
      Charlson ScoreMedian = 6
      RT indicationAdjuvant RT4 (12.5% of all Adjuvant RT)
      SBRT19 (8.7% of all SBRT)
      Concurrent ChemoRT10 (14.5% of all Concurrent ChemoRT)
      Sequential ChemoRT0
      Radical Fractionated RT19 (15.6% of all Radical Fractionated RT)
      Tumour LocationLeft Upper Lobe(LUL)12 (8% of all LUL tumours)
      Left Lower Lobe(LLL)11 (17% of LLL tumours)
      Right Upper Lobe(RUL)16 (9% of RUL tumours)
      Right Middle Lobe(RML)1 (3% of RML tumours)
      Right Lower Lobe(RLL)12 (17% of RLL tumours)

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      A clinically significant proportion of patients developed cardiac toxicity following radical radiotherapy for lung cancer. Cardiac events occur much sooner after lung cancer radiotherapy than radiotherapy for breast cancer or lymphoma. Work is ongoing to identify greater number of patients and combine local data with data from national registry to aid analysis.

      b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study

      The authors.

      213f68309caaa4ccc14d5f99789640ad Funding

      Yorkshire Cancer Research.

      682889d0a1d3b50267a69346a750433d Disclosure

      All authors have declared no conflicts of interest.


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