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放疗对中枢神经系统非恶性肿瘤患者心脏特异性死亡及相关临床特征的影响。

Effect of radiotherapy on cardiac-specific death in patients with non-malignant tumors of central nervous system and related clinical features.

作者信息

Wang Ruxin, Ye Haowen, Zhao Yongting, Ma Li, Wei Jinjing, Wang Ying, Zhang Xiaofang, Wang Lihong

机构信息

Department of Endocrinology and Metabolism, The First Affiliated Hospital of Jinan University, Guangzhou, China.

Department of Endocrinology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.

出版信息

Front Cardiovasc Med. 2022 Oct 6;9:991621. doi: 10.3389/fcvm.2022.991621. eCollection 2022.

Abstract

IMPORTANCE

Cardiac-specific death from radiation caused by radiation therapy (RT) in patients with malignant tumors has received extensive attention, however, little is known regarding the potential cardiotoxic effects of RT in patients with non-malignant tumors.

OBJECTIVES AND METHODS

In this study, we used the SEER data to explore the incidence of post-radiation cardiovascular complications in patients with non-malignant tumors of central nervous system (CNS), and identify the influencing factors of cardiac-specific death.

RESULTS

Ultimately 233, 306 patients were included (97.8% of patients had brain tumors and 2.2% had spinal cord tumors). For patients with non-malignant tumors of CNS, RT {yes (odds ratio [OR] 0.851, 95% confidence interval [CI] 0.774-0.936, = 0.001, before propensity score matching (PSM); OR 0.792, 95% CI 0.702-0.894, < 0.001, after PSM) vs. no} was associated with lower risk of cardiac-specific death, other clinical features affecting cardiac death similar to those in patients with non-malignant tumors of CNS receiving RT. For patients with non-malignant tumors of CNS receiving RT, female, married status, Hispanic ethnicity, surgery, and tumor site (brain exclude nerve and endocrine, nervous system) were associated with lower risks of cardiac-specific death, while earlier year of diagnosis, older age of diagnosis, Black, larger tumor and bilateral tumor were risk factors for cardiac-specific death.

CONCLUSIONS

Our study shows the influencing factors for cardiac-specific death in patients with non-malignant tumors of CNS, and found RT is associated with lower risk of cardiac-specific death. These results can facilitate the identification of patients with non-malignant tumors of CNS who can benefit from RT while avoiding cardiovascular events. In addition, this study helps to enhance the clinical use of RT in these populations, especially in patients who may have impaired cardiac function due to CNS tumors.

摘要

重要性

恶性肿瘤患者接受放射治疗(RT)导致的心脏特异性死亡已受到广泛关注,然而,关于RT对非恶性肿瘤患者潜在心脏毒性作用的了解却很少。

目的和方法

在本研究中,我们使用监测、流行病学和最终结果(SEER)数据来探讨中枢神经系统(CNS)非恶性肿瘤患者放疗后心血管并发症的发生率,并确定心脏特异性死亡的影响因素。

结果

最终纳入233306例患者(97.8%为脑肿瘤患者,2.2%为脊髓肿瘤患者)。对于CNS非恶性肿瘤患者,RT(是[比值比(OR)0.851,95%置信区间(CI)0.774 - 0.936,P = 0.001,倾向评分匹配(PSM)前];OR 0.792,95% CI 0.702 - 0.894,P < 0.001,PSM后)与心脏特异性死亡风险较低相关,其他影响心脏死亡的临床特征与接受RT的CNS非恶性肿瘤患者相似。对于接受RT的CNS非恶性肿瘤患者,女性、已婚状态、西班牙裔种族、手术以及肿瘤部位(脑,不包括神经和内分泌、神经系统)与心脏特异性死亡风险较低相关,而诊断年份较早、诊断年龄较大、黑人、肿瘤较大和双侧肿瘤是心脏特异性死亡的危险因素。

结论

我们的研究显示了CNS非恶性肿瘤患者心脏特异性死亡的影响因素,并发现RT与心脏特异性死亡风险较低相关。这些结果有助于识别可从RT中获益同时避免心血管事件的CNS非恶性肿瘤患者。此外,本研究有助于提高RT在这些人群中的临床应用,特别是在可能因CNS肿瘤导致心功能受损的患者中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0345/9582928/3f8a3670d100/fcvm-09-991621-g0001.jpg

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