Optimal combination of heart and lung dose parameters in radiotherapy for locally advanced non-small cell lung carcinoma: a multicenter retrospective study

Le résumé fourni par la source

This study aimed to identify the optimal combination of heart and lung dose parameters associated with overall survival (OS) in patients with locally advanced non-small cell lung carcinoma (LA-NSCLC) receiving radiotherapy. Data from 278 patients treated definitively for LA-NSCLC at three institutions between 1 April 2013 and 31 October 2021 were retrospectively analyzed. Lung and heart dose parameters were categorized into high- or low-dose groups based on predefined thresholds for subsequent analysis. Univariable analysis of OS was conducted for all dose group combinations. The combination with the lowest P-value was identified as the most promising and included in the multivariable analysis along with other clinical factors. The combinations of mean heart dose (MHD)/lung V40 (LV40) ('Vxx' denotes the percentage of organ volume receiving ≥xx Gy) and heart V5 (HV5)/LV40 yielded the lowest P-values (P = 0.021). The thresholds for these dose parameters were MHD ≤24.4 Gy, HV5 ≤63% and LV40 ≤7.7%, respectively. Multivariable analysis incorporating clinical factors identified age ≥65 years (HR: 2.06, P = 0.002), performance status ≥1 (Hazard ratio [HR]: 1.68, P = 0.024), chemoradiotherapy (HR: 0.28, P < 0.001), current smoking history (HR: 2.21, P < 0.001), gross tumor volume (HR: 1.43, P = 0.007) and the MHD/LV40 combination (HR: 2.35, P = 0.003) as independent prognostic factors. While exploratory, this study highlights the clinical significance of the MHD/LV40 combination as a prognostic factor; integrating these parameters radiotherapy for LA-NSCLC may improve patient outcomes.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.