PROGNOSTIC AND ADDED VALUE OF ECHOCARDIOGRAPHIC STRAIN FOR PREDICTION OF ADVERSE OUTCOMES IN PATIENTS WITH LOCALLY ADVANCED NON-SMALL CELL LUNG CANCER AFTER RADIOTHERAPY
PROGNOSTIC AND ADDED VALUE OF ECHOCARDIOGRAPHIC STRAIN FOR PREDICTION OF ADVERSE OUTCOMES IN PATIENTS WITH LOCALLY ADVANCED NON-SMALL CELL LUNG CANCER AFTER RADIOTHERAPY
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DOI：
10.1016/j.ultrasmedbio.2018.09.012
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发表时间：
2019-01-01
影响因子：
2.9
通讯作者：
Zhang, Qin
中科院分区：
文献类型：
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作者：
Chen, Lu;Ta, Shengjun;Zhang, Qin
放射治疗（RT）可能与心脏毒性有关，这可能会部分抵消癌症治疗的益处。我们试图在放疗后使用斑点追踪超声心动图评估亚临床心肌功能障碍，并探讨非小细胞肺癌（NSCLC）患者早期心脏影响与不良结局之间的关联。总共前瞻性招募了 112 名计划接受 RT 的 III 期 NSCLC 患者。 RT 后立即和 RT 后 6 个月 (6 m-RT) 观察到总体纵向应变 (GLS) 减少。在多变量分析中，GLS 从基线到 6 个月的百分比变化 (Delta GLS%(6) (m-RT))（风险比 = 1.202，95% 置信区间：1.095-1.320，p < 0.001）是全因死亡率的独立预测因子。根据受试者工作特征曲线分析，Delta GLS %(6) (m-RT) >= 13.65% 对于预测 NSCLC 患者的死亡率具有 65.9% 的敏感性和 85.2% 的特异性（曲线下面积 = 0.784，95% 置信区间：0.692-0.876，p < 0.001）。这些发现应该鼓励医生在放疗后尽早进行超声心动图检查。 (C) 2018 年世界超声医学与生物学联合会。版权所有。
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 (Delta GLS%(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, Delta GLS %(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. (C) 2018 World Federation for Ultrasound in Medicine & Biology. All rights reserved.