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Chemoradiation therapy for non-small cell lung cancer exacerbates thoracic aortic calcification determined by computed tomography

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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.

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Author notes

  1. Takashi Miki and Shunsaku Miyauchi contributed equally to this work.

Authors and Affiliations

  1. Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Kitaku Shikata-cho, Okayama, 700-8558, Japan

    Takashi Miki, Toru Miyoshi, Keishi Ichikawa, Kazufumi Nakamura & Hiroshi Ito

  2. Department of General Thoracic, Breast, and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan

    Shunsaku Miyauchi, Junichi Soh & Shinichi Toyooka

  3. Department of Chronic Kidney Disease and Cardiovascular Disease, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan

    Masashi Yoshida

  4. Department of Surgery, Division of Thoracic Surgery, Kindai University Faculty of Medicine, Osaka-Samaya, Japan

    Junichi Soh

  5. Department of Allergy and Respiratory Medicine, Okayama University Hospital, Okayama, Japan

    Katsuyuki Kiura

  6. Department of Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan

    Susumu Kanazawa

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  1. Takashi Miki
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Correspondence to Toru Miyoshi.

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Miki, T., Miyauchi, S., Miyoshi, T. et al. Chemoradiation therapy for non-small cell lung cancer exacerbates thoracic aortic calcification determined by computed tomography. Heart Vessels 35, 1401–1408 (2020). https://doi.org/10.1007/s00380-020-01611-2

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  • DOI: https://doi.org/10.1007/s00380-020-01611-2

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