Radiotherapy (RT) is potentially related to cardiotoxicity, which may partially offset the benefits of cancer treatment. We sought to evaluate subclinical myocardial dysfunction using speckle tracking echocardiography after RT and to explore the associations between early cardiac effects and adverse outcomes in patients with non-small cell lung cancer (NSCLC). In total, 112 patients with stage III NSCLC who were scheduled to receive RT were prospectively recruited. A reduction in global longitudinal strain (GLS) was observed immediately after RT and at 6 mo after RT (6 m-RT). In multivariable analysis, the percentage change in GLS from baseline to 6 mo (ΔGLS%6 m-RT) (hazard ratio = 1.202, 95% confidence interval: 1.095-1.320, p < 0.001) was an independent predictor of all-cause mortality. Based on receiver operating characteristic curve analysis, ΔGLS%6 m-RT ≥13.65% had 65.9% sensitivity and 85.2% specificity for predicting mortality in NSCLC patients (area under the curve = 0.784, 95% confidence interval: 0.692-0.876, p < 0.001). These findings should encourage physicians to perform echocardiography early after RT.
Keywords: Cardiotoxicity; Echocardiography; Non-small cell lung cancer; Radiotherapy; Strain.
Copyright © 2018 World Federation for Ultrasound in Medicine 8 Biology. Published by Elsevier Inc. All rights reserved.