Analysis of influencing factors of acute radiation-induced heart damage after radiotherapy in patients with non-small cell lung cancer
Objective To explore the influencing factors of acute radiation-induced heart damage(RIHD)after radiotherapy in patients with non-small cell lung cancer(NSCLC).Methods The clinical data of 97 NSCLC patients who received radiotherapy from Jan 2019 to May 2023 in our hospital were retrospectively analyzed.The patients were divided into the RIHD group(n=30)and the control group(n=67)according to whether acute RIHD occurred after radiotherapy.Clinical data including age,gender etc.were compared between the two groups,and the variables with significant differences between the two groups were substituted into Logistic regression model to screen the influencing factors of acute RIHD after radiotherapy in NSCLC patients.Value of influencing factors predicting occurrence of acute RIHD after radiotherapy in NSCLC patients were evaluated by plotting receiver operating characteristic(ROC)curve and calculating the area under the curve(AUC).Results Diastolic blood pressure in the RIHD group was higher than that in the control group,proportion of patients with history of old myocardial infarction,proportion of patients with history of percutaneous coronary intervention,and brain natriuretic peptide(BNP)level in the RIHD group were higher than those in the control group,and left ventricular ejection fraction(LVEF)level was lower than that in the control group,the differences were statistically significant(P<0.05).Logistic regression showed that a high level of LVEF was a protective factor for the occurrence of RIHD,and a high BNP level was an independent risk factor for the development of acute RIHD(P<0.05).The AUCs of LVEF and BNP alone predicting the occurrence of acute RIHD were 0.680(95%CI:0.575～0.785)and 0.716(95%CI:0.613～0.820),and the AUC of the combination of LVEF and BNP predicting the occurrence of acute RIHD was 0.797(95%CI:0.702～0.891).Conclusion LVEF and BNP are significant predictors of acute RIHD in NSCLC patients undergoing radiotherapy.
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