Incidence and risk factors of short-term cardiovascular events in esophageal cancer patients undergoing radiotherapy

Summary Advances in cancer treatment have improved survival rates, but radiation induced cardiovascular events remain a concern, especially in esophageal cancer patients undergoing radiotherapy. This study investigates the incidence and risk factors for cardiovascular events in this population. From 2009 to 2016, 5302 esophageal cancer patients were analyzed in the retrospective case control study. Patients were categorized based on the occurrence of cardiovascular events, and analyses of the association between radiotherapy and cardiovascular events. Demographic data, comorbidities, and treatment details were assessed. Adjusted odds ratios (aORs) for risk factors were calculated. Among the patients, 209 (3.94%) developed cardiovascular events. These patients were older (61.83 ± 11.78 vs. 56.18 ± 10.18 years, P < 0.001) and had higher rates of coronary artery disease, chronic obstructive pulmonary disease, chronic kidney disease, and hypertension. Radiotherapy was not significantly associated with increased cardiovascular risk (aOR: 0.99, 95% CI: 0.59–1.65), but heart failure (HF) and cardiomyopathy showed a numerically higher incidence in survivors (aOR: 3.69, 95% CI: 0.90–15.13). Arrhythmias (52.15%) and HF (25.36%) were the most frequent complications, occurring within a median of 6.38 months. The 12-month mortality rate was 48.43%. Cardiovascular complications remain a concern in esophageal cancer patients post-radiotherapy, especially in elderly individuals with comorbidities. Early risk assessment, multidisciplinary care, and careful attention to radiation dose and systemic therapy are critical.