Dosimetric predictors of asymptomatic heart valvular dysfunction following mediastinal irradiation for Hodgkin's lymphoma

Laura Cella, Raffaele Liuzzi, Manuel Conson, Gabriella Torre, Michele Caterino, Nicola De Rosa, Marco Picardi, Luigi Camera, Raffaele Solla, Antonio Farella, Marco Salvatore, Roberto Pacelli

Research output: Contribution to journalArticle

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Abstract

Purpose: To identify dose-heart-volume constraints that correlate with the risk of developing asymptomatic valvular defects (VD) in Hodgkin's lymphoma (HL) patients treated with three-dimensional radiotherapy (RT). Patients and methods: Fifty-six patients undergoing cytotoxic chemotherapy (CHT) and involved-field radiation treatment for HL were retrospectively analyzed. Electro-echocardiography was performed before CHT, after CHT, and after RT. For the entire heart, for right and left ventricle (RV, LV), right and left atrium (RA, LA) percentage of volume exceeding 5-30 Gy in increment of 5 Gy (V x), and dosimetric parameters were calculated using 1.6 Gy fraction as reference. To evaluate clinical and dosimetric factors possibly associated with VD, univariate and multivariate logistic regression analyses were performed. Results: At a median follow up of 70.5 months, 32.1% of patients developed VD (regurgitation and/or stenosis): 25.0% developed mitral, 5.4% developed aortic, and 14.3% tricuspid VD. In particular the percentage of LA exceeding 25 Gy (LA-V 25) and the percentage of LV exceeding 30 Gy (LV-V 30) correlated with mitral and aortic VD with an odds ratio (OR) of 5.7 (LA-V 25 > 63.0% vs. LA-V 25 ≤ 63.0%) and OR of 4.4 (LV-V 30 > 25% vs. LV-V 30 ≤ 25%), respectively. RV-V 30 correlated with tricuspid VD (OR = 7.2, RV-V 30 > 65% vs. RV-V 30 ≤ 65%). Conclusion: LA-V 25, LV- and RV-V 30 prove to be predictors of asymptomatic alteration of valve functionality.

Original languageEnglish
Pages (from-to)316-321
Number of pages6
JournalRadiotherapy and Oncology
Volume101
Issue number2
DOIs
Publication statusPublished - Nov 2011

Fingerprint

Hodgkin Disease
Odds Ratio
Heart Atria
Drug Therapy
Heart Ventricles
Radiotherapy
Cardiac Volume
Echocardiography
Pathologic Constriction
Logistic Models
Regression Analysis
Radiation
Therapeutics

Keywords

  • Dosimetric constraints
  • Hodgkin's lymphoma
  • Radiotherapy
  • Valvular defects

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Hematology

Cite this

Dosimetric predictors of asymptomatic heart valvular dysfunction following mediastinal irradiation for Hodgkin's lymphoma. / Cella, Laura; Liuzzi, Raffaele; Conson, Manuel; Torre, Gabriella; Caterino, Michele; De Rosa, Nicola; Picardi, Marco; Camera, Luigi; Solla, Raffaele; Farella, Antonio; Salvatore, Marco; Pacelli, Roberto.

In: Radiotherapy and Oncology, Vol. 101, No. 2, 11.2011, p. 316-321.

Research output: Contribution to journalArticle

Cella, L, Liuzzi, R, Conson, M, Torre, G, Caterino, M, De Rosa, N, Picardi, M, Camera, L, Solla, R, Farella, A, Salvatore, M & Pacelli, R 2011, 'Dosimetric predictors of asymptomatic heart valvular dysfunction following mediastinal irradiation for Hodgkin's lymphoma', Radiotherapy and Oncology, vol. 101, no. 2, pp. 316-321. https://doi.org/10.1016/j.radonc.2011.08.040
Cella, Laura ; Liuzzi, Raffaele ; Conson, Manuel ; Torre, Gabriella ; Caterino, Michele ; De Rosa, Nicola ; Picardi, Marco ; Camera, Luigi ; Solla, Raffaele ; Farella, Antonio ; Salvatore, Marco ; Pacelli, Roberto. / Dosimetric predictors of asymptomatic heart valvular dysfunction following mediastinal irradiation for Hodgkin's lymphoma. In: Radiotherapy and Oncology. 2011 ; Vol. 101, No. 2. pp. 316-321.
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abstract = "Purpose: To identify dose-heart-volume constraints that correlate with the risk of developing asymptomatic valvular defects (VD) in Hodgkin's lymphoma (HL) patients treated with three-dimensional radiotherapy (RT). Patients and methods: Fifty-six patients undergoing cytotoxic chemotherapy (CHT) and involved-field radiation treatment for HL were retrospectively analyzed. Electro-echocardiography was performed before CHT, after CHT, and after RT. For the entire heart, for right and left ventricle (RV, LV), right and left atrium (RA, LA) percentage of volume exceeding 5-30 Gy in increment of 5 Gy (V x), and dosimetric parameters were calculated using 1.6 Gy fraction as reference. To evaluate clinical and dosimetric factors possibly associated with VD, univariate and multivariate logistic regression analyses were performed. Results: At a median follow up of 70.5 months, 32.1{\%} of patients developed VD (regurgitation and/or stenosis): 25.0{\%} developed mitral, 5.4{\%} developed aortic, and 14.3{\%} tricuspid VD. In particular the percentage of LA exceeding 25 Gy (LA-V 25) and the percentage of LV exceeding 30 Gy (LV-V 30) correlated with mitral and aortic VD with an odds ratio (OR) of 5.7 (LA-V 25 > 63.0{\%} vs. LA-V 25 ≤ 63.0{\%}) and OR of 4.4 (LV-V 30 > 25{\%} vs. LV-V 30 ≤ 25{\%}), respectively. RV-V 30 correlated with tricuspid VD (OR = 7.2, RV-V 30 > 65{\%} vs. RV-V 30 ≤ 65{\%}). Conclusion: LA-V 25, LV- and RV-V 30 prove to be predictors of asymptomatic alteration of valve functionality.",
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AU - Cella, Laura

AU - Liuzzi, Raffaele

AU - Conson, Manuel

AU - Torre, Gabriella

AU - Caterino, Michele

AU - De Rosa, Nicola

AU - Picardi, Marco

AU - Camera, Luigi

AU - Solla, Raffaele

AU - Farella, Antonio

AU - Salvatore, Marco

AU - Pacelli, Roberto

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N2 - Purpose: To identify dose-heart-volume constraints that correlate with the risk of developing asymptomatic valvular defects (VD) in Hodgkin's lymphoma (HL) patients treated with three-dimensional radiotherapy (RT). Patients and methods: Fifty-six patients undergoing cytotoxic chemotherapy (CHT) and involved-field radiation treatment for HL were retrospectively analyzed. Electro-echocardiography was performed before CHT, after CHT, and after RT. For the entire heart, for right and left ventricle (RV, LV), right and left atrium (RA, LA) percentage of volume exceeding 5-30 Gy in increment of 5 Gy (V x), and dosimetric parameters were calculated using 1.6 Gy fraction as reference. To evaluate clinical and dosimetric factors possibly associated with VD, univariate and multivariate logistic regression analyses were performed. Results: At a median follow up of 70.5 months, 32.1% of patients developed VD (regurgitation and/or stenosis): 25.0% developed mitral, 5.4% developed aortic, and 14.3% tricuspid VD. In particular the percentage of LA exceeding 25 Gy (LA-V 25) and the percentage of LV exceeding 30 Gy (LV-V 30) correlated with mitral and aortic VD with an odds ratio (OR) of 5.7 (LA-V 25 > 63.0% vs. LA-V 25 ≤ 63.0%) and OR of 4.4 (LV-V 30 > 25% vs. LV-V 30 ≤ 25%), respectively. RV-V 30 correlated with tricuspid VD (OR = 7.2, RV-V 30 > 65% vs. RV-V 30 ≤ 65%). Conclusion: LA-V 25, LV- and RV-V 30 prove to be predictors of asymptomatic alteration of valve functionality.

AB - Purpose: To identify dose-heart-volume constraints that correlate with the risk of developing asymptomatic valvular defects (VD) in Hodgkin's lymphoma (HL) patients treated with three-dimensional radiotherapy (RT). Patients and methods: Fifty-six patients undergoing cytotoxic chemotherapy (CHT) and involved-field radiation treatment for HL were retrospectively analyzed. Electro-echocardiography was performed before CHT, after CHT, and after RT. For the entire heart, for right and left ventricle (RV, LV), right and left atrium (RA, LA) percentage of volume exceeding 5-30 Gy in increment of 5 Gy (V x), and dosimetric parameters were calculated using 1.6 Gy fraction as reference. To evaluate clinical and dosimetric factors possibly associated with VD, univariate and multivariate logistic regression analyses were performed. Results: At a median follow up of 70.5 months, 32.1% of patients developed VD (regurgitation and/or stenosis): 25.0% developed mitral, 5.4% developed aortic, and 14.3% tricuspid VD. In particular the percentage of LA exceeding 25 Gy (LA-V 25) and the percentage of LV exceeding 30 Gy (LV-V 30) correlated with mitral and aortic VD with an odds ratio (OR) of 5.7 (LA-V 25 > 63.0% vs. LA-V 25 ≤ 63.0%) and OR of 4.4 (LV-V 30 > 25% vs. LV-V 30 ≤ 25%), respectively. RV-V 30 correlated with tricuspid VD (OR = 7.2, RV-V 30 > 65% vs. RV-V 30 ≤ 65%). Conclusion: LA-V 25, LV- and RV-V 30 prove to be predictors of asymptomatic alteration of valve functionality.

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