Reduction of heart volume during neoadjuvant chemoradiation in patients with resectable esophageal cancer

Nadia Haj Mohammad; Martijn Kamphuis; Maarten C C M Hulshof; Lotte J Lutkenhaus; Suzanne S Gisbertz; Jacques J G H M Bergman; H A C M Rianne de Bruin-Bon; Elisabeth D Geijsen; Arjan Bel; S Mathijs Boekholdt; Hanneke W M van Laarhoven

doi:10.1016/j.radonc.2014.12.005

Reduction of heart volume during neoadjuvant chemoradiation in patients with resectable esophageal cancer

Nadia Haj Mohammad, Martijn Kamphuis, Maarten C C M Hulshof, Lotte J Lutkenhaus, Suzanne S Gisbertz, Jacques J G H M Bergman, H A C M Rianne de Bruin-Bon, Elisabeth D Geijsen, Arjan Bel, S Mathijs Boekholdt, Hanneke W M van Laarhoven

Dept of Medical Oncology

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND AND PURPOSE: Neoadjuvant chemoradiation (nCRT) followed by surgery is considered curative intent treatment for patients with resectable esophageal cancer. The aim was to establish hemodynamic aspects of changes in heart volume and to explore whether changes in heart volume resulted in clinically relevant changes in the dose distribution of radiotherapy.

METHODS: A prospective study was conducted in patients who were treated with nCRT consisting of carboplatin and paclitaxel concomitant with radiotherapy (41.4 Gy/1.8 Gy per fraction). Physical parameters, cardiac volume on CT and Cone beam CT, cardiac blood markers and cardiac ultrasound were obtained.

RESULTS: In 23 patients a significant decrease of 55.3 ml in heart volume was detected (95% CI 36.7-73.8 ml, p<0.001). There was a decrease in both systolic (mean decrease 18 mmHg, 95% CI 11-26 mmHg, p<0.001) and diastolic blood pressure (mean decrease 8 mmHg, 95% CI 2-14 mmHg, p=0.008) and an increase in heart rate with 6 beats/min (95% CI 1-11 beats/min, p=0.021). Except for Troponin T, no change in other cardiac markers and echocardiography parameters were observed. The change in heart volume did not result in a clinically relevant change in radiation dose distribution.

CONCLUSION: Heart volume was significantly reduced, but was not accompanied by overt cardiac dysfunction. All observed changes in hemodynamic parameters are consistent with volume depletion. Adaptation of the treatment plan during the course of radiotherapy is not advocated.

Original language	English
Pages (from-to)	91-95
Number of pages	5
Journal	Radiotherapy & Oncology
Volume	114
Issue number	1
DOIs	https://doi.org/10.1016/j.radonc.2014.12.005
Publication status	Published - Jan 2015

Keywords

Aged
Antineoplastic Combined Chemotherapy Protocols
Blood Pressure
Carboplatin
Cardiac Volume
Chemoradiotherapy, Adjuvant
Esophageal Neoplasms
Female
Humans
Male
Middle Aged
Neoadjuvant Therapy
Paclitaxel
Prospective Studies
Radiation Dosage
Radiotherapy Dosage
Esophageal cancer
Neoadjuvant chemoradiation

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10.1016/j.radonc.2014.12.005

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Haj Mohammad, N., Kamphuis, M., Hulshof, M. C. C. M., Lutkenhaus, L. J., Gisbertz, S. S., Bergman, J. J. G. H. M., de Bruin-Bon, H. A. C. M. R., Geijsen, E. D., Bel, A., Boekholdt, S. M., & van Laarhoven, H. W. M. (2015). Reduction of heart volume during neoadjuvant chemoradiation in patients with resectable esophageal cancer. Radiotherapy & Oncology, 114(1), 91-95. https://doi.org/10.1016/j.radonc.2014.12.005

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title = "Reduction of heart volume during neoadjuvant chemoradiation in patients with resectable esophageal cancer",

abstract = "BACKGROUND AND PURPOSE: Neoadjuvant chemoradiation (nCRT) followed by surgery is considered curative intent treatment for patients with resectable esophageal cancer. The aim was to establish hemodynamic aspects of changes in heart volume and to explore whether changes in heart volume resulted in clinically relevant changes in the dose distribution of radiotherapy.METHODS: A prospective study was conducted in patients who were treated with nCRT consisting of carboplatin and paclitaxel concomitant with radiotherapy (41.4 Gy/1.8 Gy per fraction). Physical parameters, cardiac volume on CT and Cone beam CT, cardiac blood markers and cardiac ultrasound were obtained.RESULTS: In 23 patients a significant decrease of 55.3 ml in heart volume was detected (95% CI 36.7-73.8 ml, p<0.001). There was a decrease in both systolic (mean decrease 18 mmHg, 95% CI 11-26 mmHg, p<0.001) and diastolic blood pressure (mean decrease 8 mmHg, 95% CI 2-14 mmHg, p=0.008) and an increase in heart rate with 6 beats/min (95% CI 1-11 beats/min, p=0.021). Except for Troponin T, no change in other cardiac markers and echocardiography parameters were observed. The change in heart volume did not result in a clinically relevant change in radiation dose distribution.CONCLUSION: Heart volume was significantly reduced, but was not accompanied by overt cardiac dysfunction. All observed changes in hemodynamic parameters are consistent with volume depletion. Adaptation of the treatment plan during the course of radiotherapy is not advocated.",

keywords = "Aged, Antineoplastic Combined Chemotherapy Protocols, Blood Pressure, Carboplatin, Cardiac Volume, Chemoradiotherapy, Adjuvant, Esophageal Neoplasms, Female, Humans, Male, Middle Aged, Neoadjuvant Therapy, Paclitaxel, Prospective Studies, Radiation Dosage, Radiotherapy Dosage, Esophageal cancer, Neoadjuvant chemoradiation",

author = "{Haj Mohammad}, Nadia and Martijn Kamphuis and Hulshof, {Maarten C C M} and Lutkenhaus, {Lotte J} and Gisbertz, {Suzanne S} and Bergman, {Jacques J G H M} and {de Bruin-Bon}, {H A C M Rianne} and Geijsen, {Elisabeth D} and Arjan Bel and Boekholdt, {S Mathijs} and {van Laarhoven}, {Hanneke W M}",

year = "2015",

month = jan,

doi = "10.1016/j.radonc.2014.12.005",

language = "English",

volume = "114",

pages = "91--95",

journal = "Radiotherapy & Oncology",

issn = "0167-8140",

publisher = "Elsevier Ireland Ltd",

number = "1",

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Haj Mohammad, N, Kamphuis, M, Hulshof, MCCM, Lutkenhaus, LJ, Gisbertz, SS, Bergman, JJGHM, de Bruin-Bon, HACMR, Geijsen, ED, Bel, A, Boekholdt, SM & van Laarhoven, HWM 2015, 'Reduction of heart volume during neoadjuvant chemoradiation in patients with resectable esophageal cancer', Radiotherapy & Oncology, vol. 114, no. 1, pp. 91-95. https://doi.org/10.1016/j.radonc.2014.12.005

TY - JOUR

T1 - Reduction of heart volume during neoadjuvant chemoradiation in patients with resectable esophageal cancer

AU - Haj Mohammad, Nadia

AU - Kamphuis, Martijn

AU - Hulshof, Maarten C C M

AU - Lutkenhaus, Lotte J

AU - Gisbertz, Suzanne S

AU - Bergman, Jacques J G H M

AU - de Bruin-Bon, H A C M Rianne

AU - Geijsen, Elisabeth D

AU - Bel, Arjan

AU - Boekholdt, S Mathijs

AU - van Laarhoven, Hanneke W M

PY - 2015/1

Y1 - 2015/1

N2 - BACKGROUND AND PURPOSE: Neoadjuvant chemoradiation (nCRT) followed by surgery is considered curative intent treatment for patients with resectable esophageal cancer. The aim was to establish hemodynamic aspects of changes in heart volume and to explore whether changes in heart volume resulted in clinically relevant changes in the dose distribution of radiotherapy.METHODS: A prospective study was conducted in patients who were treated with nCRT consisting of carboplatin and paclitaxel concomitant with radiotherapy (41.4 Gy/1.8 Gy per fraction). Physical parameters, cardiac volume on CT and Cone beam CT, cardiac blood markers and cardiac ultrasound were obtained.RESULTS: In 23 patients a significant decrease of 55.3 ml in heart volume was detected (95% CI 36.7-73.8 ml, p<0.001). There was a decrease in both systolic (mean decrease 18 mmHg, 95% CI 11-26 mmHg, p<0.001) and diastolic blood pressure (mean decrease 8 mmHg, 95% CI 2-14 mmHg, p=0.008) and an increase in heart rate with 6 beats/min (95% CI 1-11 beats/min, p=0.021). Except for Troponin T, no change in other cardiac markers and echocardiography parameters were observed. The change in heart volume did not result in a clinically relevant change in radiation dose distribution.CONCLUSION: Heart volume was significantly reduced, but was not accompanied by overt cardiac dysfunction. All observed changes in hemodynamic parameters are consistent with volume depletion. Adaptation of the treatment plan during the course of radiotherapy is not advocated.

AB - BACKGROUND AND PURPOSE: Neoadjuvant chemoradiation (nCRT) followed by surgery is considered curative intent treatment for patients with resectable esophageal cancer. The aim was to establish hemodynamic aspects of changes in heart volume and to explore whether changes in heart volume resulted in clinically relevant changes in the dose distribution of radiotherapy.METHODS: A prospective study was conducted in patients who were treated with nCRT consisting of carboplatin and paclitaxel concomitant with radiotherapy (41.4 Gy/1.8 Gy per fraction). Physical parameters, cardiac volume on CT and Cone beam CT, cardiac blood markers and cardiac ultrasound were obtained.RESULTS: In 23 patients a significant decrease of 55.3 ml in heart volume was detected (95% CI 36.7-73.8 ml, p<0.001). There was a decrease in both systolic (mean decrease 18 mmHg, 95% CI 11-26 mmHg, p<0.001) and diastolic blood pressure (mean decrease 8 mmHg, 95% CI 2-14 mmHg, p=0.008) and an increase in heart rate with 6 beats/min (95% CI 1-11 beats/min, p=0.021). Except for Troponin T, no change in other cardiac markers and echocardiography parameters were observed. The change in heart volume did not result in a clinically relevant change in radiation dose distribution.CONCLUSION: Heart volume was significantly reduced, but was not accompanied by overt cardiac dysfunction. All observed changes in hemodynamic parameters are consistent with volume depletion. Adaptation of the treatment plan during the course of radiotherapy is not advocated.

KW - Aged

KW - Antineoplastic Combined Chemotherapy Protocols

KW - Blood Pressure

KW - Carboplatin

KW - Cardiac Volume

KW - Chemoradiotherapy, Adjuvant

KW - Esophageal Neoplasms

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Neoadjuvant Therapy

KW - Paclitaxel

KW - Prospective Studies

KW - Radiation Dosage

KW - Radiotherapy Dosage

KW - Esophageal cancer

KW - Neoadjuvant chemoradiation

U2 - 10.1016/j.radonc.2014.12.005

DO - 10.1016/j.radonc.2014.12.005

M3 - Article

C2 - 25630429

SN - 0167-8140

VL - 114

SP - 91

EP - 95

JO - Radiotherapy & Oncology

JF - Radiotherapy & Oncology

IS - 1

ER -

Reduction of heart volume during neoadjuvant chemoradiation in patients with resectable esophageal cancer

Abstract

Keywords

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