Chemoradiation therapy for non-small cell lung cancer exacerbates thoracic aortic calcification determined by computed t
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ORIGINAL ARTICLE
Chemoradiation therapy for non‑small cell lung cancer exacerbates thoracic aortic calcification determined by computed tomography Takashi Miki1 · Shunsaku Miyauchi2 · Toru Miyoshi1 · Masashi Yoshida3 · Keishi Ichikawa1 · Junichi Soh2,4 · Kazufumi Nakamura1 · Katsuyuki Kiura5 · Susumu Kanazawa6 · Shinichi Toyooka2 · Hiroshi Ito1 Received: 5 January 2020 / Accepted: 17 April 2020 © Springer Japan KK, part of Springer Nature 2020
Abstract Preoperative chemoradiation therapy (CRT) has been considered as an effective treatment for non-small cell lung cancer. However, there is concern that CRT progresses atherosclerosis in cancer survivors. This study sought to determine if preoperative CRT exacerbated thoracic aortic calcification (TAC) detected by computed tomography (CT) in patients with lung cancer. Among 473 patients who underwent surgery for lung cancer at Okayama University Hospital between 2011 and 2015, 34 patients undergoing preoperative CRT and surgery (CRT group) and 33 matched patients undergoing initial surgery (non-CRT group) were analyzed and compared. The volume of TAC between the 2nd and 12th thoracic vertebrae was quantitatively measured by CT at baseline and 1-year follow-up. Patients in the CRT group (62 ± 7 years old, 74% male) received cisplatin chemotherapy with docetaxel or vinorelbine and radiation therapy (mean 47.3 ± 4.0 Gy). The percent change in TAC volume was significantly greater in the CRT compared with the non-CRT group (58.7%, 95% confidence interval [CI] 41.7–75.7% vs. 27.2%, 95% CI 9.9–44.4%; p = 0.01). Multivariate logistic regression analysis identified CRT as an independent factor associated with greater TAC progression (> the median value) (odds ratio 3.63, 95% CI 1.19–11.08; p = 0.02). In conclusion, preoperative CRT for lung cancer exacerbates TAC. Follow-up of such patients should thus include careful longitudinal assessment for cardiovascular disease. Keywords Chemoradiation · Lung cancer · Atherosclerosis · Cardiovascular disease
Introduction Lung cancer has become the leading cause of cancerrelated death worldwide [1], although advances in treatment have improved patient survival. However, in addition to cancer recurrence, cancer survivors face other challenges, including cardiovascular diseases (CVDs), Takashi Miki and Shunsaku Miyauchi contributed equally to this work. * Toru Miyoshi [email protected]‑u.ac.jp 1
2
Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2‑5‑1 Kitaku Shikata‑cho, Okayama 700‑8558, Japan Department of General Thoracic, Breast, and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan
related to the long-term side effects of anticancer therapies [2]. CVD may be a direct side effect of the cancer treatment, or to the accelerated development of existing CVD. Chemoradiation therapy (CRT) followed by surgery has been considered as an effective treatment for non-small cell lung
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