TY - JOUR
T1 - Cardiac substructure radiotherapy dose and changes in physical activity and quality of life after chemoradiotherapy for NSCLC
T2 - a secondary analysis of the CLARITY prospective study
AU - Yegya-Raman, Nikhil
AU - Ko, Kyunga
AU - Han, Ivy S.
AU - Mitchell, Joshua D.
AU - Zou, Wei
AU - Ohri, Nitin
AU - Jabbour, Salma K.
AU - Mak, Raymond H.
AU - Robinson, Clifford
AU - Levin, William P.
AU - Barrett, Leanne
AU - Xia, Congying
AU - Berlin, Eva
AU - Bravo, Paco
AU - Carli, Marcelo Di
AU - Cohen, Roger
AU - Hutton, Sandra
AU - Keltz, Jonathan
AU - Wang, Jessica
AU - Fasan, Omotayo
AU - Nagda, Suneel N.
AU - Seo, Angie
AU - Smith, Amanda M.
AU - Sun, Lova
AU - Soike, Michael
AU - Kole, Adam J.
AU - Walls, Gerard
AU - Feigenberg, Steven J.
AU - Ky, Bonnie
N1 - Publisher Copyright:
© 2025 The Authors
PY - 2026/1
Y1 - 2026/1
N2 - Purpose: The objective was to assess associations between cardiac substructure dose and changes in patient-reported outcomes (PROs) post-chemoradiotherapy for non-small cell lung cancer (NSCLC). Methods and Materials: The study population was derived from CLARITY (NCT04305613), a multi-institutional longitudinal prospective cohort study. Patients treated with conventionally fractionated radiotherapy (1.8–2 Gy per fraction) with concurrent chemotherapy completed physical activity (Godin) and quality of life (FACIT-Fatigue and Dyspnea) questionnaires at baseline, completion of radiotherapy, 6 and 12 months post-radiotherapy. Thirty cardiac dosimetric parameters were a priori selected from centrally contoured radiotherapy plans: mean dose, maximum dose, volume receiving ≥ 5 Gy (V5Gy), V15Gy, and V30Gy to the whole heart, left ventricle, right ventricle, left atrium, right atrium, and left anterior descending coronary artery, and applied to a LASSO regression model to further define variable importance. Associations between cardiac radiation dose metrics and changes in PROs were assessed using repeated-measures linear regression via generalized estimating equations with correction for multiple testing. Results: In a subcohort of 122 patients, the median age was 67 years, 57% were male, and 41% had prevalent cardiovascular disease. Median whole heart mean dose was 9 Gy, whole heart maximum dose was 64 Gy, and LAD V15Gy was 1%. Godin physical activity (p = 0.0499), FACIT-Fatigue (p < 0.001), and FACIT-Dyspnea scores (p = 0.0037) worsened from baseline to end of radiotherapy, then recovered to baseline levels thereafter. In multivariable analysis and after adjusting for multiple comparisons, no cardiac dose metric was significantly associated with a worsening in patient-reported physical activity, fatigue or dyspnea (p > 0.05). Conclusions: PROs worsened from baseline to the end of thoracic chemoradiotherapy, then recovered to baseline levels. Cardiac radiation dose metrics were not associated with these changes.
AB - Purpose: The objective was to assess associations between cardiac substructure dose and changes in patient-reported outcomes (PROs) post-chemoradiotherapy for non-small cell lung cancer (NSCLC). Methods and Materials: The study population was derived from CLARITY (NCT04305613), a multi-institutional longitudinal prospective cohort study. Patients treated with conventionally fractionated radiotherapy (1.8–2 Gy per fraction) with concurrent chemotherapy completed physical activity (Godin) and quality of life (FACIT-Fatigue and Dyspnea) questionnaires at baseline, completion of radiotherapy, 6 and 12 months post-radiotherapy. Thirty cardiac dosimetric parameters were a priori selected from centrally contoured radiotherapy plans: mean dose, maximum dose, volume receiving ≥ 5 Gy (V5Gy), V15Gy, and V30Gy to the whole heart, left ventricle, right ventricle, left atrium, right atrium, and left anterior descending coronary artery, and applied to a LASSO regression model to further define variable importance. Associations between cardiac radiation dose metrics and changes in PROs were assessed using repeated-measures linear regression via generalized estimating equations with correction for multiple testing. Results: In a subcohort of 122 patients, the median age was 67 years, 57% were male, and 41% had prevalent cardiovascular disease. Median whole heart mean dose was 9 Gy, whole heart maximum dose was 64 Gy, and LAD V15Gy was 1%. Godin physical activity (p = 0.0499), FACIT-Fatigue (p < 0.001), and FACIT-Dyspnea scores (p = 0.0037) worsened from baseline to end of radiotherapy, then recovered to baseline levels thereafter. In multivariable analysis and after adjusting for multiple comparisons, no cardiac dose metric was significantly associated with a worsening in patient-reported physical activity, fatigue or dyspnea (p > 0.05). Conclusions: PROs worsened from baseline to the end of thoracic chemoradiotherapy, then recovered to baseline levels. Cardiac radiation dose metrics were not associated with these changes.
UR - https://www.scopus.com/pages/publications/105021853063
U2 - 10.1016/j.ctro.2025.101070
DO - 10.1016/j.ctro.2025.101070
M3 - Article
C2 - 41334108
AN - SCOPUS:105021853063
SN - 2405-6308
VL - 56
JO - Clinical and Translational Radiation Oncology
JF - Clinical and Translational Radiation Oncology
M1 - 101070
ER -