Analysis of influencing factors for cardiac death after radiotherapy with or without chemotherapy for middle-or lower-thoracic esophageal cancer
Shen Wenbin,Gao Hongmei,Zhu Shuchai,Li Youmei,Cao Yankun,Liu Zhikun,Li Shuguang,Su Jingwei,Li Juan
Department of Radiation Oncology,The Forth Hospital,Hebei Medical University,Shijiazhaung 050011,China (Shen WB,Zhu SHCH,Li YM,Cao YK,Liu ZHK,Li SHG,Su JW,Li J)Department of Radiation,The First Hospital of Shijiazhaung,Shijiazhaung 050011,China (Gao HM)
Abstract：Objective To analyze the influencing factors for cardiac death (CD) after radical radiotherapy with or without chemotherapy in patients with middle-or lower-thoracic esophageal cancer. Methods The clinical data of 140 patients who met the inclusion criteria were analyzed retrospectively, as well as the effect of cardiac dose-volume factors suggested by dose-volume histogram in the therapeutic regimen on CD. Chi-square test was applied for comparison of categorical data between groups, and independent-samples t-test was applied for comparison of continuous data between groups;logistic regression analysis was applied to analyze the association of cardiac dose-volume and clinical factors with CD. Results A total of 103 patients died, including 8 patients with CD (7.8%). The univariate analysis of CD showed that age ≥70 years (P=0.033), a history of diabetes (P=0.043), lower-thoracic esophageal cancer (P=0.017), and the length of esophageal lesions>5 cm on esophagography (P=0.013) were risk factors for CD, and heart Dmean(P=0.032) and heart V50(P=0.045) were influencing factors. The results of ROC curve analysis showed that heart Dmean could effectively predict CD (P=0.044), with a cut-off value of 3325 cGy. The results of multivariate logistic analysis showed that the length of esophageal lesions on esophagography (P=0.013) and heart Dmean(P=0.034) were independent prognostic factors for CD. Conclusions The length of esophageal lesions on esophagography and heart Dmean were independent prognostic factors for CD, and the value of heart Dmean can effectively predict CD;therefore, it is suggested that the value of heart Dmean be controlled during the development of therapeutic regimens.
Shen Wenbin,Gao Hongmei,Zhu Shuchai et al. Analysis of influencing factors for cardiac death after radiotherapy with or without chemotherapy for middle-or lower-thoracic esophageal cancer[J]. Chinese Journal of Radiation Oncology, 2016, 25(1): 32-36.
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2016, Vol. 25 
