Chemotherapy and radiation therapy for lung cancer linked to cardiac disorders
Research Activities, June 2011, No. 370
Chemotherapy, radiation therapy, and the combination of chemotherapy and radiation therapy have been shown to result in increased survival time of patients with non-small-cell lung cancer (NSCLC). Since chemotherapy may affect healthy cells as well as cancer cells and radiation therapy in high doses can compromise the heart, a research team from the University of Texas sought to investigate the likelihood of an increased risk of developing cardiac disorders following the administration of these forms of therapy in NSCLC patients. They found that all three modalities of treatment—chemotherapy only, radiation therapy only, and chemoradiation—were associated with increased risks for developing cardiac dysfunction. Persons at highest risk were men, blacks, older patients, those with more coexisting illness, and those with advanced disease.
Patients who received chemotherapy only were more likely to develop ischemic heart disease and heart failure, while those who received chemoradiation were at increased risk for conduction disorders and heart failure. The study also found an increased risk of ischemic heart disease in patients with left-sided tumors treated with radiation only and with chemoradiation given to both lungs. The risk for cardiac dysfunction following chemoradiation was above that for chemotherapy only and radiation therapy only.
The researchers used the Surveillance, Epidemiology, and End Results (SEER) Program-Medicare linked data files to gather information about incident cancer cases and cancer-directed therapy. The final study sample consisted of 34,209 patients aged 65 and over with stages I-IV NSCLC who were diagnosed from 1991 to 2002. The study was supported by the Agency for Healthcare Research and Quality (HS16743).
See "Cardiac toxicity in association with chemotherapy and radiation therapy in a large cohort of older patients with non-small-cell lung cancer," by Dale Hardy, Ph.D., Chih-Chin Liu, M.S., Janice N. Cormier, M.D., M.P.H., and others in the Annals of Oncology 21, pp. 1825-1833, 2010.