Radiotherapy may confer poor long-term CV survival in patients with certain cancers
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Among individuals with certain cancers, treatment with radiotherapy was associated with poorer long-term CV-specific survival compared with those who did not undergo radiotherapy, researchers reported.
“Cancer-related treatment, such as chemotherapy with anthracycline antibiotics and/or radiotherapy, may be responsible for the increased incidence of CVD deaths among patients with cancer, especially if the heart is in the radiation field,” Enrui Liu, MD, of the National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College in Beijing, and colleagues wrote. “We performed a comprehensive analysis to investigate the association between radiotherapy and CVD deaths in patients with cancer. In addition, we compared the incidence of CVD deaths among patients with cancer who underwent radiotherapy with the incidence of CVD deaths in the general population.”
Utilizing data from 16 U.S. sites, extracted from the Surveillance, Epidemiology and End Results database, researchers evaluated the association between radiotherapy and CV-specific survival. They calculated the standardized mortality ratio for CVD deaths by comparing the observed deaths of patients with cancer treated with radiotherapy with the expected deaths in the general population.
Of more than 2.2 million patients with cancer identified for the present analysis, 13.19% died of CVD.
Researchers observed that radiotherapy was an independent predictor of CV-specific survival among patients with lung and bronchus cancer (HR = 1.09; 95% CI, 1.06-1.13; P < .001), cervix uteri cancer (HR = 1.47; 95% CI, 1.36-1.59; P < .001), corpus uteri cancer (HR = 1.13; 95% CI, 1.09-1.17; P < .001) and urinary bladder cancer (HR = 1.13; 95% CI, 1.07-1.2; P < .001).
Among patients with lung and bronchus, cervix uteri, corpus uteri and urinary bladder cancers, radiotherapy was associated with lower 40-year CV-specific survival compared with patients who did not undergo radiotherapy (P for all < .001).
When compared with the general population, there was a 13% increase in CVD deaths among all patients with cancer (standardized mortality ratio = 1.13; 95% CI, 1.13-1.14).
“The results of the present study showed that patients with cancer who underwent radiotherapy had a higher incidence of CVD deaths than the general population,” the researchers wrote. “Similar trends were observed in subgroups stratified according to age at diagnosis, year of diagnosis and follow-up duration. These results suggest that attention should be paid to the risk of CVD deaths in patients with cancer undergoing radiotherapy. Efforts should be made to prevent cardiotoxicity and maximize outcomes, while ensuring that the therapeutic effect of the treatment is not compromised.”
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