A new study warns patients treated for non-small cell lung cancer (NSCLC) are at an increased risk of heart attack and heart failure. Researchers from the Brigham and Women's Hospital and Dana-Farber Cancer Institute examined the outcomes of patients who received treatment for locally advanced NSCLC. The findings showed an average radiation dose delivered to the heart was linked with an increased risk of severe cardiovascular events and even death.
"This is alarming data—to think that one in 10 of the patients I'm treating for this type of cancer will go on to have a heart attack or other major cardiac event,"senior author Raymond Mak, MD, a thoracic radiation oncologist at the Brigham and Dana-Farber, told a news portal. Adding, "These cardiac events are happening earlier and more often than previously thought. More patients are living long enough to experience this risk of cardiac toxicity. We need to start paying attention to this and working together with cardiologists to help these patients."
For the study, the team examined the data and outcomes for almost 748 NSCLC patients treated with thoracic radiotherapy at the Dana-Farber/Brigham and Women's Cancer Center and Dana-Farber Cancer Institute/Brigham and Women's Hospital at Milford Regional Medical Center.The team discovered 77 patients suffered a major cardiac event that included heart attack and heart failure after treatment. The higher the dosages of heart radiation exposure the more it was likely for patients to experience a heart attack. This was especially true for those patients who did not have coronary heart disease prior to undergoing radiotherapy.
"When treating patients with lung cancer, it's a balance of risks," study author Katelyn Atkins, MD, Ph.D., a resident in the Harvard Radiation Oncology Residency Program, told a news portal. Adding, "But we need to start thinking about where there's room for improvement in optimizing treatment for patients and room for improvement in terms of collaborating with primary care physicians and cardiologists."
The findings highlight the need to have a lower cardiac radiation therapy dose for patients at risk of a cardiac event. "When possible, we should be thinking about ways to minimize cardiac radiation dose," Mak told a news portal. Adding, "Recognising that we may not always be able to do that, we're now collaborating with our cardiology colleagues to explore early interventions to help mitigate the effects of cardiac injury from radiation therapy."
Lung cancer is one of the deadliest forms of the disease and is a major cause of cancer deaths across the globe. Radiation to the heart is sometimes the only treatment option for many patients with lung cancer. Screening for lung cancer and treating the disease with immunotherapies have improved survival rates for many patients.For patients with locally advanced NSCLC, the average survival time is close to two years or more.
The study's findings were originally published in the Journal of the American College of Cardiology.