Correction to: Cardiotoxicity following thoracic radiotherapy for lung cancer (British Journal of Cancer, (2025), 132, 4, (311-325), 10.1038/s41416-024-02888-0)

Correction to: British Journal of Cancer; https://doi.org/10.1038/s41416-024-02888-0, Published online 06 November 2024 During the proofing process for this article, the authors requested that the rows in Table 1 be sorted by the number present in Column A ‘Author and Year’; this was overlooked by the publisher. Table 1 has been corrected accordingly. Furthermore, the article was mistakenly published with black and white figures, which has also been corrected. (Table presented.) Summary characteristics and findings of the peer-reviewed, retrospective, clinical cardiac dosimetry studies in relation to cardiotoxicity. Author & Year Cohort Type Stage Average EQD2 (Gy) Follow-Up (months) Type Baseline Toxicity Endpoint Planning Constraints DVHs MHD Structures Atlas Key Study Findings Schytte 2010 [1] RWD I–III 60–80Gy in 2Gy #* 17.3 3DCRT 250 None Primary: Cardiac events (list included) OS NR Dmean NR LV, bilateral ventricles, heart NR 15% patients had a cardiac events. DVHs were negative for both events and OS on MVA. Han 2014 [2] RWD I–III 60–85.5Gy in 2–3.8Gy #* NR 3DCRT 100 “CVD”, HTN OS D33≤66Gy, D66 ≤45Gy, D100 ≤40Gy Dmax, Vx in 5Gy increments NR PA RTOG DVHs positive for OS on MVA. Tucker 2016 [3] RWD III 60–76Gy in 1.8–2Gy#* 24.0 3DCRT (41%) IMRT (49%) IMPT (10%) 468 None OS NR Dmean, V5, V30 16.6 Heart NR DVHs negative for OS on MVA. Speirs 2017 [4] RWD II–III 50–84.9Gy in 1.5–2.8Gy #* 14.5 3DCRT (60%) IMRT (40%) 322 None Cardiac events OS NR Dmean, Dmax, Vx in 5Gy increments 2.6 (3DCRT) 1.8 (IMRT) Heart Wheatley 24% patients had a grade 3 event. DVHs positive for OS on MVA. Vivekanandan 2017 [5] Trial II–III 63–73Gy in 30#* 25.0 3DCRT (96%) VMAT (4%) 78 Pre-existing ECG only OS ECG change at 6 months D100 <45Gy, D67 <53Gy, D33 <60% PCAs 10.3 Pericardium, AVN, 4 chambers, 4 chamber walls Feng DVHs positive for OS on MVA. 38% patients had ECG changes. DVHs negative for ECG changes on MVA. Dess 2017 [6] Trial II–III 70 23.0 3DCRT (97%) IMRT (3%) 125 HTN, DM, "Pre-existing disease" G3+ events G2+ events, OS V40 <100%, V65 <33% Dmean, V5, V30, V50 11.0 Heart Feng 15% patients had a cardiac event. DVHs positive on MVA. DVHs positive for OS on MVA. Wang 2017 [7] Trial III 70–90Gy in 23-45#* NR 3DCRT 112 CAD Symptomatic events OS, PCE V40 <100%, LV V40 <100% Dmean, V30, V5, LV V30, LV V5 12.0 Heart Feng 23% patients had a cardiac event. DVHs positive on MVA. DVHs negative for OS on MVA. Wang 2017 [8] Trial III 70–90Gy in 23-45#* NR 3DCRT 112 CAD PCE, ACS, arrhyth OS V40 <100%, LV V40 <100% Dmean, V5, V30, V60 12.0 Feng for chambers, LAD + automated pericardium Feng 8%, 7%, 11% of patients had a PCE, ACS, and arrhythmia events. DVHs positive on UVA (no MVA). DVHs negative for OS on MVA. Johnson 2017 [9] RWD II–III 60–74Gy in 1.8–2Gy #* 16.8 3DCRT (38%) IMRT (62%) 86 None OS None V5, V30 NR Heart NR DVHs positive for OS on MVA. Ma 2017 [10] RWD I–III 60–76Gy in 30–38#* 16.9 3DCRT (89%) IMRT (11%) 141 HTN OS V30 ≤40-60%, V40 ≤ 30-50% Dmean, Dmax, Vx in 5Gy increments 5.2 Heart, PA RTOG DVHs positive for OS on MVA. Stam 2017 [11] RWD II–III 70.1 55.0 IMRT 469 None OS Dmax ≤40Gy, D66 ≤50Gy, D33 ≤66Gy V0.5, V1, V2, V3, V4 and Vx in 5Gy increments & equivalent uniform dose N/A Heart Feng DVHs positive for OS on MVA. Guberina 2017 [12] Trial III 45Gy in 30# +/- 26Gy in 13#* 72.0 3DCRT 155 None OS NR Dmean, V5 13.8-17.4 Heart Feng DVHs negative for OS on MVA. McWilliam 2017 [13] RWD NR 55Gy / 20# NR 3DCRT (NR) /IMRT (NR) 1101 / 89 (SABR) None OS NR Dmax NR Heart base region (not delineated) N/A Voxel-based analysis with positive MVA for a dose region approximating to the heart base Yegya-Raman 2018 [14] RWD II–IV 60–66Gy in 1.8–2Gy #* 47.4 3DCRT (64%) 3DCRT +IMRT (16%) IMRT (19%) 140 CAD, “significant arrhythmia, pericardial disease, HF without CAD, valve disease Symptomatic events OS V40 <100%, MHD <26Gy as per QUANTEC 2010 Dmean, V5, V30, V50 15.8 4x chambers, LAD Feng 29% of patients had an event. DVHs positive on MVA. DVHs negative for OS on MVA. Lee 2018 [15] RWD III 55–70Gy in 1.8–2.75Gy #* 17.6 3DCRT (42%) IMRT/ VMAT (58%) 120 DM, IHD (with definition) MI OS “QUANTEC” (from 2010) Dmean, V5, V25, V30, V40, V50, D30 12.6 Heart RTOG MI occurred in 4%. DVHs negative for MI on MVA. DVHs positive for OS on MVA. Lee 2019 [16] RWD I–III 50–54Gy in 1.8–2Gy #* 36.6 3DCRT (70%) IMRT/ VMAT (30%) 43 DM, IHD (with definition) MI OS Dmean ≤40Gy, V60 ≤33%, V40 ≤80%, V45 ≤60%, V60 ≤33% Dmean, V5, V25, V30, V40, V50, D30 9.4 Heart NR No MI events occurred. DVHs negative for OS on MVA. Borkenhagen 2019 [17] RWD I–IV 44–69Gy in 14–34#* 13.2 NR 76 DM, PVD, "Previous cardiac disease" Cardiac events OS NR Dmean, Dmax, V30, V45 N/A Atria, ventricles, pericardium, coronary space Wheatley 7%, 21%, 1% of patients had atrial arrhythmia effusions, valve disease. DVHs positive on MVA. DVHs negative for OS on MVA. Atkins 2019 [18] RWD II–III 50–66Gy in 1.8–2Gy #* 20.4 3DCRT (76%) IMRT (24%) 748 HTN, Lipids, DM, VTE, arrhythmia, valve disease, PVD, stroke, CAD, MI, HF MACE G3+ events, OS None pre-2008, V30 <50%, V45 <40%, V60 <20% thereafter Dmean, V5, V30 12.3 Heart Feng 10% of patients had MACE. DVHs positive on MVA. DVHs positive for OS on MVA. Hotca 2019 [19] RWD III 50–80Gy in 1.8–2Gy #* 20.0 IMRT 155 DM, DL, HTN, cardiac disease (list included) ECG Changes NR PCAs, Dmin, Dmean, Dmax NR Chambers, great vessels Feng 66%, 35% and 67% patients had an ECG change that was arrhythmic, ischaemic/pericarditic, or non-specific. DVHs positive on UVA (MVA not done). McWilliam 2020 [20] RWD III 55Gy/20# NR 3DCRT (NR) /IMRT (NR) 978 None OS NR Dmax NR Heart base region (not delineated) N/A Voxel-based analysis with positive MVA for a dose region approximating to the heart base McWilliam 2020 [21] RWD III 55Gy/20# NR 3DCRT (NR) /IMRT (NR) 648 None OS NR Dmax NR Right atrium surface (not delineated) N/A Surface dose mapping analysis with positive MVA for a dose region approximating to the right atrium Thor 2020 [22] Trial III 60 or 74Gy in 2Gy #* 24.0 3DCRT (52) /IMRT (48) 306 training /131 validation None OS Heart V33 <60Gy, V66 <45Gy, V100 <40Gy Dmean, Dmax, Dmin, MOHX% Dmean, Dmax, and in 5Gy increments NR Heart, pericardium, bilateral atria, bilateral ventricles RTOG Model combining atria D45, lung Dmean, pericardium MOH55, and ventricles MOH5. Jang 2020 [23] RWD III 50 – 72 Gy/25 – 36# 27.5 3DCRT (NR) /IMRT (NR) 258 HTN, DM, CV disease OS NR Mean, V5, V10, V20, V30, V40, V50, and V60 NR WH, RA, LA, RV, LV NR MVA positive for LV in patients with cardiac history only Vivekanandan 2021 [24] RWD I–III 69 38.0 3DCRT (75%) VMAT (25%) 64 "Baseline cardiac comorbidity" OS NR Dmean, Vx in multiple thresholds 7.6 Heart, LA Feng DVHs positive for OS on MVA. Sheperd 2021 [25] RWD I–III 45–70Gy in 1.8–2Gy#* 64.0 3DCRT (30%) IMRT (70%) 284 None OS V30 ≤50% Dmean, Dmin, Dmax plus Vx in 5Gy increments 11.2 Heart RTOG DVHs positive for OS on MVA. Xu 2021 [26] Trial II–IV 60–74Gy in 2Gy # * 26.2 IMRT (61%)/Protons (39%) 225 “Pre-existing heart disease” Cardiac events OS V30 <50%, V45 <40%, V60 <20% Dmean, Dmax, Vx in 5Gy increments 12.0 Heart, pericardium, chambers RTOG 25% of patients had a cardiac event. DVHs not positive for events on UVA. (No MVA). DVHs not positive for OS on UVA. (No MVA). Atkins 2021 [27] RWD II–III 50–66Gy in 1.8–2Gy #* NR 3DCRT (76%) IMRT (24%) 701 HTN, Lipids, DM, VTE, arrhythmia, valve disease, PVD, stroke, CAD, MI, HF MACE G3+ events, OS None pre-2008, V30 <50%, V45 <40%, V60 <20% thereafter Dmean, Dmax, Vx in 5Gy incre(26)ments 12.3 Chambers & coronaries Feng DVHs positive for both MACE and OS. Niska 2021 [28] RWD III 43.1–74Gy in 1.8–2Gy #* 18.0 3DCRT (41%)/IMRT (59%) 119 None OS Dmax <62Gy, Dmean <26Gy, V30 <46%, V40 <33% Vx in 5Gy increments NR Heart NR DVHs positive for OS on MVA. McKenzie 2022 [29] Trial III 60Gy in 30# or 74Gy in 37#* 22.9 3DCRT (54%) IMRT (46%) 439 None OS None Dmean, LAD V15 NR Heart, LAD Feng DVHs positive for OS. Yu 2022 [30] RWD III 50–72Gy in 20–36# (IMPT) or 45–66Gy in 15–33#* 25.5 IMPT (21%) IMRT/ VMAT (79%) 163 HTN, CAD, DM Cardiac events NR Dmean, Dmax, V5, V10, V20, V30, V40, 3 (IMPT)/ 9 (IMRT) Heart NR 12% of patients had an event after IMRT/VMAT, 0% after IMPT. Cho 2022 [31] RWD III 60–66Gy in 2–2.4Gy #* 45.0 3DCRT (83%)/3DCRT +IMRT (3%) /IMRT (14%) 133 Pre-existing heart disease (list included) G2+ cardiac events None mandatory Dmean, V5, V30, V50 8.3 Heart, LV wall NR 32% patients had a cardiac event. DVHs positive for events on MVA. Craddock 2022 [32] Trial II–III 60 – 74 Gy/30 – 37# NR 3DCRT (NR) /IMRT (NR) 172 LVEF OS V40 ≤50% Dmax NR Heart base region (not delineated) N/A Voxel-based analysis with positive MVA for a dose region approximating to the heart base Kim 2022 [33] RWD I–III 60-64.5Gy in 30#* 36.2 3DCRT (34%) IMRT (66%) 321 BMI, DM, AF, valve disease, CAD, CHB, stroke, PVD, CAC, alcohol Cardiac events OS Dmean <45Gy Dmean, Dmax, Vx in 5Gy increments 12.3 Chambers, coronaries, conduction nodes Feng, Loap 5% of patients had AF. 2% had non-AF events. DVHs positive for AF on MVA. DVHs positive for OS on MVA. Banfill 2022 [34] RWD I–IV >45Gy in 20#* NR NR 967 HTN, IHD, Myocardial, Pericardial & Valve disease, Arrhythmia (list included) Cardiac death V30 <40%, V40 <30% (from 2015) Dmean, V5, V30, V50, 12.8 Heart UK SABR Consortium Guidance DVHs positive for OS on MVA. No 2023 [35] RWD IIB–IIIC NR 74 3DCRT (<1%)/ IMRT (25%)/ VMAT (75%) 233 DM, HTN, previous CV event Myocardial, conductive, constrictive, valvular NR Mean, V7, V15, V27 9.3 WH, LV, LMC, RCA, LCX, LAD, Total left coronary arteries Duane 22% patients had a cardiac event. Total left associated with cardiac events on MVA McWilliam 2023 [36] Trial III 60 – 74 Gy/30 – 37# 24 3DCRT (NR) /IMRT (NR) 458 None OS V40 <100%, V45 <66%, V60 <33% V5, V30 NR Heart and heart base region (not delineated) NR Voxel-based analysis with positive MVA for a dose region approximating to the heart base Yegya-Raman 2023 [37] RWD II–IV 66Gy/33# 29.9 3DCRT (11%)/IMRT (36%)/ proton (57%) 187 / 140 Cardiac comorbidity, CAD Death without progression OS MHD <26Gy Mean, V5, V30, V50 8.1 Heart, Feng Ventricle metrics MVA positive for DWP and OS. Yegya-Raman 2024 [38] RWD II–IIIC 66–70 Gy/33–35# 39.6 3DCRT (6%)/IMRT (59%)/ proton (35%) 335 HTN, DM, Lipids, previous atrial arrhythmia MACE Cardiac events, OS MHD <20Gy, V50 <25% Mean, Dmin, Dmax, V5-70 8.7 Heart, LV, LAD Feng 10.4% patients had a MACE. MVA positive for OS only, for MHD and LAD V15 Olloni 2024 [39] RWD NR 24–33 # NR 3DCRT (9%) / IMRT (41%)/ VMAT (50%) 644 Arrhythmia and “baseline heart disease” OS NR V2 – V70 (2Gy intervals) 11.3 WH, RA, LA, RV, LV, LMC, LCX, LAD, RCA NR (auto) MVA positive for OS (2 x PCAs) Walls 2024 [40] RWD I–III 55–84 Gy/20–42# NR 3DCRT (29%)/IMRT (20%)/ VMAT (51%) 478 HTN, DM, Lipids, previous MI, previous HF, previous arrhythmia OS MI, HF, arrhythmia MHD <26Gy Dmax NR Heart base region Christie Definition 17% patients had a cardiac event. MVA positive for both endpoints Walls 2024 [41] RWD I–III 55Gy/20# NR 3DCRT (20%)/ IMRT (30%)/ VMAT (50%) 420 HTN, DM, Lipids, previous MI, previous HF, previous arrhythmia AF MHD <26Gy Mean, V5, V55 NR Pulmonary veins Walls 6% patients developed AF. MVA positive Atkins 2024 [42] RWD II–III 50–66Gy in 1.8–2Gy #* 20.4 3DCRT (76%) IMRT (24%) 748 HTN, Lipids, DM, VTE, arrhythmia, valve disease, PVD, stroke, CAD, MI, HF G3 arrhythmia subtypes None pre-2008, V30 <50%, V45 <40%, V60 <20% thereafter Dmean, Dmax, Vx in 5Gy increments 12.3 Chambers, coronaries, PVs, nodes Feng 17% experienced ≥1 G3 arrhythmia. On MVA analyses, PVs associated with AF and SVT, LMC with VT/asystole, LCX with atrial flutter, and the RCA with bradyarrhythmia (* = EQD2 not reported, so physical prescription provided). The figures within the PDF version of the original article were inadvertently published in black and white; they have been replaced with the original, colour versions provided by the authors at the time of submission. The original article has been corrected.