Abstract
BackgroundEarly screening and diagnosis of radiation‐induced heart disease (RIHD) is difficult in patients with chest radiation exposure. sST‐2 is involved in myocardial stress or injury. We evaluated the relationship between heart dose parameters and sST‐2 changes in chest malignant tumor patients who received chest radiation.MethodsWe prospectively collected thoracic malignancy cancer patients who had received chest radiotherapy. Heart dosimetry parameters were extracted from the treatment planning system. sST‐2 was measured at baseline, the middle stage, and after radiotherapy (recorded as pre‐ST‐2, mid‐ST‐2, and post‐ST‐2). sST‐2 change rate was calculated. Scatter plots showed the relationship between cardiac dose parameters and ST‐2 change rate. Multiple regression was used to analyze the relationship between cardiac dose parameters and ST‐2 change rate.ResultsTotally, 60 patients were enrolled. The mean V5, V10, V20, V30, V40, and MHD was 60.93 ± 27.79%, 51.43 ± 25.44%, 39.17 ± 21.75%, 28.07 ± 17.15%,18.66 ± 12.18%, and 18.60 ± 8.63 Gy, respectively. The median M‐LAD was 11.31 (IQR 3.33‐18.76) Gy. The mean pre‐ST‐2, mid‐ST‐2, and post‐ST‐2 was 5.1 ± 3.8, 6.4 ± 3.9, and 7.6 ± 4.4, respectively. sST‐2 was elevated with thoracic irradiation (P < .001). Multivariate linear regression analyses showed that V5, V10, V20, and MHD were independently and positively associated with ST‐2 change rate (β = .04, .04, .04, and .10, respectively, all P < .05).ConclusionSerum sST‐2 levels were elevated over time during radiotherapy. V5, V10, V20 and MHD were independently and positively associated with the elevated ST‐2 change rate.
Highlights
Thoracic radiotherapy (RT) is one of the main treatments for lung cancer,[1,2] esophageal cancer,[3] and thymoma.4Cardiotoxicity is a serious problem threatening the survival and quality of life of patients undergoing thoracic radiotherapy.[5]
IL-33 is a specific ligand of ST-2L, forming the IL-33/ST-2 signaling pathway, which is involved in myocardial stress or injury.[11,12]
We evaluated early changes in serum soluble ST-2 isoforms (sST-2) levels during thoracic radiotherapy and determined associations between heart dosimetry parameters and ST-2 change rate
Summary
Thoracic radiotherapy (RT) is one of the main treatments for lung cancer,[1,2] esophageal cancer,[3] and thymoma.4Cardiotoxicity is a serious problem threatening the survival and quality of life of patients undergoing thoracic radiotherapy.[5]. Screening and diagnosis of RIHD are difficult in patients with radiation exposure. Multiple studies revealed that elevated sST-2 concentration is involved in various heart diseases, such as heart failure,[13-15] atrial fibrillation,[16] heart transplant recipients,[17,18] chronic kidney disease-induced cardiac remodeling,[19] and myocardial infarction.[11,20]. When patients receive chest radiotherapy, the heart is exposed to large doses of X-rays in a short duration, especially in central lung tumors and esophageal cancer. The effect of chest radiation on sST-2 and whether changes in sST-2 levels are associated with cardiac doses was unclear. We examined sST-2 levels in the serum of patients receiving high-dose radiotherapy for thoracic malignancies. We evaluated early changes in serum sST-2 levels during thoracic radiotherapy and determined associations between heart dosimetry parameters and ST-2 change rate
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
