Cardiac CT reveals high prevalence of coronary artery disease in esophageal cancer eligible for radiotherapy
Background: Assessment of cardiac disease before cancer therapy is crucial, as advancements in cancer treatment have led to prolonged survival and an increase in cardiovascular complications. Specifically, esophageal cancer and heart disease share common risk factors, such as smoking and obesity. Ra...
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| Format: | Article |
| Language: | English |
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Medical Journals Sweden
2025-02-01
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| Series: | Acta Oncologica |
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| Online Access: | https://medicaljournalssweden.se/actaoncologica/article/view/42563 |
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| author | Akinori Takada Satoshi Nakamura Yutaka Toyomasu Takamitsu Mase Tomoko Kawamura Suguru Araki Yoshitaka Suzuki Masaki Ohi Hajime Sakuma Yoshihito Nomoto Kakuya Kitagawa |
| author_facet | Akinori Takada Satoshi Nakamura Yutaka Toyomasu Takamitsu Mase Tomoko Kawamura Suguru Araki Yoshitaka Suzuki Masaki Ohi Hajime Sakuma Yoshihito Nomoto Kakuya Kitagawa |
| author_sort | Akinori Takada |
| collection | DOAJ |
| description | Background: Assessment of cardiac disease before cancer therapy is crucial, as advancements in cancer treatment have led to prolonged survival and an increase in cardiovascular complications. Specifically, esophageal cancer and heart disease share common risk factors, such as smoking and obesity. Radiation therapy (RT) for esophageal cancer is associated with elevated cardiac radiation exposure. This study aimed to assess the prevalence of coronary artery disease (CAD) in patients with esophageal cancer who were eligible for RT.
Methods: We examined the prevalence of coronary artery stenosis, abnormal myocardial perfusion, and late enhancement using pre-RT cardiac computed tomography (CT) data of 41 patients with thoracic esophageal cancer who were referred for RT between January 2017 and June 2023 and had no history of ischemic heart disease.
Results: The median age of the 41 patients was 71 years, with 40 patients being male. Cardiac CT identified significant coronary stenosis (≥50% luminal narrowing) in 18 patients (44%), among whom 9 (50%) had severe stenosis, multivessel disease, or myocardial ischemia. Significant stenosis was most frequently observed in the left anterior descending artery (16/18). Late enhancement, indicating myocardial infarction, was observed in seven patients (17%).
Interpretation: Patients with esophageal cancer without a history of ischemic heart disease had a high prevalence (44%) of CAD, with half of them having severe stenosis, multivessel disease, or myocardial ischemia. Given the high prevalence of coronary stenosis, pre-treatment cardiac evaluation is crucial for patients with esophageal cancer. Incorporating cardiac CT findings into radiotherapy planning is recommended to optimize patient care.
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| format | Article |
| id | doaj-art-f4d1d01fe19244e08cd820b84a4997e4 |
| institution | Kabale University |
| issn | 1651-226X |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Medical Journals Sweden |
| record_format | Article |
| series | Acta Oncologica |
| spelling | doaj-art-f4d1d01fe19244e08cd820b84a4997e42025-02-03T13:12:07ZengMedical Journals SwedenActa Oncologica1651-226X2025-02-016410.2340/1651-226X.2025.42563Cardiac CT reveals high prevalence of coronary artery disease in esophageal cancer eligible for radiotherapyAkinori Takada0https://orcid.org/0000-0002-1944-2971Satoshi Nakamura1Yutaka Toyomasu2Takamitsu Mase3Tomoko Kawamura4Suguru Araki5Yoshitaka Suzuki6Masaki Ohi7Hajime Sakuma8Yoshihito Nomoto9Kakuya Kitagawa10Department of Radiology, Mie University Hospital, Tsu city, Mie, JapanDepartment of Advanced Diagnostic Imaging, Mie University Graduate School of Medicine, Tsu, JapaDepartment of Radiology, Mie University Hospital, Tsu city, Mie, JapanDepartment of Radiology, Mie University Hospital, Tsu city, Mie, JapanDepartment of Radiology, Mie University Hospital, Tsu city, Mie, JapanDepartment of Radiology, Mie University Hospital, Tsu city, Mie, JapanDepartment of Radiology, Mie University Hospital, Tsu city, Mie, JapanDepartment of Gastrointestinal and Pediatric Surgery, Mie University Hospital, Mie, JapanDepartment of Radiology, Mie University Graduate School of Medicine, Tsu city Mie, JapanDepartment of Radiology, Mie University Graduate School of Medicine, Tsu city Mie, JapanDepartment of Advanced Diagnostic Imaging, Mie University Graduate School of Medicine, Tsu, Japan; Department of Gastrointestinal and Pediatric Surgery, Mie University Hospital, Mie, JapanBackground: Assessment of cardiac disease before cancer therapy is crucial, as advancements in cancer treatment have led to prolonged survival and an increase in cardiovascular complications. Specifically, esophageal cancer and heart disease share common risk factors, such as smoking and obesity. Radiation therapy (RT) for esophageal cancer is associated with elevated cardiac radiation exposure. This study aimed to assess the prevalence of coronary artery disease (CAD) in patients with esophageal cancer who were eligible for RT. Methods: We examined the prevalence of coronary artery stenosis, abnormal myocardial perfusion, and late enhancement using pre-RT cardiac computed tomography (CT) data of 41 patients with thoracic esophageal cancer who were referred for RT between January 2017 and June 2023 and had no history of ischemic heart disease. Results: The median age of the 41 patients was 71 years, with 40 patients being male. Cardiac CT identified significant coronary stenosis (≥50% luminal narrowing) in 18 patients (44%), among whom 9 (50%) had severe stenosis, multivessel disease, or myocardial ischemia. Significant stenosis was most frequently observed in the left anterior descending artery (16/18). Late enhancement, indicating myocardial infarction, was observed in seven patients (17%). Interpretation: Patients with esophageal cancer without a history of ischemic heart disease had a high prevalence (44%) of CAD, with half of them having severe stenosis, multivessel disease, or myocardial ischemia. Given the high prevalence of coronary stenosis, pre-treatment cardiac evaluation is crucial for patients with esophageal cancer. Incorporating cardiac CT findings into radiotherapy planning is recommended to optimize patient care. https://medicaljournalssweden.se/actaoncologica/article/view/42563esophageal cancerradiation therapycardiovascular complicationsmyocardial perfusionintensity-modulated radiation therapyproton beam therapy |
| spellingShingle | Akinori Takada Satoshi Nakamura Yutaka Toyomasu Takamitsu Mase Tomoko Kawamura Suguru Araki Yoshitaka Suzuki Masaki Ohi Hajime Sakuma Yoshihito Nomoto Kakuya Kitagawa Cardiac CT reveals high prevalence of coronary artery disease in esophageal cancer eligible for radiotherapy Acta Oncologica esophageal cancer radiation therapy cardiovascular complications myocardial perfusion intensity-modulated radiation therapy proton beam therapy |
| title | Cardiac CT reveals high prevalence of coronary artery disease in esophageal cancer eligible for radiotherapy |
| title_full | Cardiac CT reveals high prevalence of coronary artery disease in esophageal cancer eligible for radiotherapy |
| title_fullStr | Cardiac CT reveals high prevalence of coronary artery disease in esophageal cancer eligible for radiotherapy |
| title_full_unstemmed | Cardiac CT reveals high prevalence of coronary artery disease in esophageal cancer eligible for radiotherapy |
| title_short | Cardiac CT reveals high prevalence of coronary artery disease in esophageal cancer eligible for radiotherapy |
| title_sort | cardiac ct reveals high prevalence of coronary artery disease in esophageal cancer eligible for radiotherapy |
| topic | esophageal cancer radiation therapy cardiovascular complications myocardial perfusion intensity-modulated radiation therapy proton beam therapy |
| url | https://medicaljournalssweden.se/actaoncologica/article/view/42563 |
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