Key result
Higher left atrial radiation dose during lung SBRT linked to ~2.9-fold higher mortality.
Why the study?
To investigate the association between radiation dose to the heart base and other cardiac substructures and overall survival following stereotactic body radiation therapy for central and ultracentral lung tumors.
Does higher radiation dose to specific cardiac substructures reduce overall survival in patients with central and ultracentral lung tumors treated with SBRT?
Cohort (n=88)
Does higher radiation dose to specific cardiac substructures reduce overall survival in patients with central and ultracentral lung tumors treated with SBRT?
Hazard Ratio: 2.89
Absolute Event Rate: 70% vs 89%
p-value: p=0.04
Higher radiation doses to specific upper-cardiac substructures during thoracic SBRT are independently associated with worse overall survival, indicating a need for stringent substructure-specific dose constraints in treatment planning.
Supports left atrial/SVC dose sparing in lung SBRT planning; hypothesis-generating for prospective validation of constraints.
Purpose: This study investigates the association between radiation dose to the heart base and other cardiac substructures and overall survival (OS) following stereotactic body radiation therapy (SBRT) for central and ultracentral lung tumors. Methods and Materials: ) were converted to equivalent 2 Gy fractions (EQD₂, α/β = 3 Gy). Optimal dose cut-points were defined to stratify patients into high- and low-dose groups. Cox regression models, adjusted for age, sex, tumor type, and volume, assessed the association between cardiac dose and OS; additional sensitivity analyses included bronchial Dmax. Results: = .05). Conclusions: Higher radiation doses to the left atrium, superior vena cava, and right ventricle were independently associated with worse OS after SBRT for central and ultracentral lung tumors, underscoring the importance of cardiac-substructure-specific dose constraints in SBRT planning. Moreover, a clear trend toward reduced survival with higher doses to the base of the heart underscores the importance of this region as a potential target for future dose-sparing strategies.
No takes yet. Share an insight, caveat, or question.
Kalinauskaitė et al. (2026) conducted a cohort in Central or ultracentral primary lung carcinoma or lung metastases (n=88). Higher radiation dose to cardiac substructures (e.g., left atrium) vs. Lower radiation dose to cardiac substructures was evaluated on Overall Survival (HR 2.89, p=0.04). Higher mean radiation doses to the left atrium (HR 2.89) and superior vena cava (HR 2.56) were independently associated with significantly worse overall survival following SBRT for lung tumors.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: