Becker von Rose Aaron, Kobus Kathrin, Bohmann Bianca, Lindquist-Lilljequist Moritz, Eilenberg Wolf, Kapalla Marvin, Bassermann Florian, Reeps Christian, Eckstein Hans-Henning, Neumayer Christoph, Brostjan Christine, Roy Joy, von Heckel Korbinian, Hultgren Rebecka, Schwaiger Benedikt J, Combs Stephanie E, Busch Albert, Schiller Kilian
III. Medical Department for Hematology and Oncology, University Hospital rechts der Isar, Technical University Munich, Munich, Germany.
Department for Vascular and Endovascular Surgery, University Hospital rechts der Isar, Technical University Munich, Munich, Germany.
Strahlenther Onkol. 2024 May;200(5):425-433. doi: 10.1007/s00066-023-02135-0. Epub 2023 Sep 7.
Co-prevalence of abdominal aortic aneurysm (AAA) and cancer poses a unique challenge in medical care since both diseases and their respective therapies might interact. Recently, reduced AAA growth rates were observed in cancer patients that received radiation therapy (RT). The purpose of this study was to perform a fine-grained analysis of the effects of RT on AAA growth with respect to direct (infield) and out-of-field (outfield) radiation exposure, and radiation dose-dependency.
A retrospective single-center analysis identified patients with AAA, cancer, and RT. Clinical data, radiation plans, and aneurysm diameters were analyzed. The total dose of radiation to each aneurysm was computed. AAA growth under infield and outfield exposure was compared to patients with AAA and cancer that did not receive RT (no-RT control) and to an external noncancer AAA reference cohort.
Between 2003 and 2020, a total of 38 AAA patients who had received well-documented RT for their malignancy were identified. AAA growth was considerably reduced for infield patients (n = 18) compared to outfield patients (n = 20), albeit not significantly (0.8 ± 1.0 vs. 1.3 ± 1.6 mm/year, p = 0.28). Overall, annual AAA growth in RT patients was lower compared to no-RT control patients (1.1 ± 1.5 vs. 1.8 ± 2.2 mm/year, p = 0.06) and significantly reduced compared to the reference cohort (1.1 ± 1.5 vs. 2.7 ± 2.1 mm/year, p < 0.001). The pattern of AAA growth reduction due to RT was corroborated in linear regression analyses correcting for initial AAA diameter. A further investigation with respect to dose-dependency of radiation effects on AAA growth, however, revealed no apparent association.
In this study, both infield and outfield radiation exposure were associated with reduced AAA growth. This finding warrants further investigation, both in a larger scale clinical cohort and on a molecular level.
腹主动脉瘤（AAA）与癌症的共同患病率给医疗护理带来了独特挑战，因为这两种疾病及其各自的治疗方法可能会相互影响。最近，在接受放射治疗（RT）的癌症患者中观察到AAA生长速率降低。本研究的目的是针对直接（靶区内）和靶区外辐射暴露以及辐射剂量依赖性，对RT对AAA生长的影响进行细粒度分析。
一项回顾性单中心分析确定了患有AAA、癌症且接受过RT的患者。分析了临床数据、放射治疗计划和动脉瘤直径。计算每个动脉瘤的总辐射剂量。将靶区内和靶区外暴露情况下的AAA生长情况与未接受RT的AAA和癌症患者（非RT对照组）以及外部非癌症AAA参考队列进行比较。
在2003年至2020年期间，共确定了38例因恶性肿瘤接受了详细记录的RT的AAA患者。与靶区外患者（n = 20）相比，靶区内患者（n = 18）的AAA生长显著降低，尽管差异不显著（0.8±1.0 vs. 1.3±1.6毫米/年，p = 0.28）。总体而言，RT患者的AAA年生长率低于非RT对照患者（1.1±1.5 vs. 1.8±2.2毫米/年，p = 0.06），与参考队列相比显著降低（1.1±1.5 vs. 2.7±2.1毫米/年，p < 0.001）。在对初始AAA直径进行校正的线性回归分析中，证实了RT导致AAA生长降低的模式。然而，关于辐射对AAA生长影响的剂量依赖性的进一步研究未发现明显关联。
在本研究中，靶区内和靶区外辐射暴露均与AAA生长降低有关。这一发现值得在更大规模的临床队列和分子水平上进一步研究。
