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

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

doi:10.3389/fcvm.2022.991621

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

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

Authors

Ruxin Wang¹, Haowen Ye¹, Yongting Zhao², Li Ma³, Jinjing Wei¹, Ying Wang¹, Xiaofang Zhang⁴, Lihong Wang¹

Affiliations

¹ Department of Endocrinology and Metabolism, The First Affiliated Hospital of Jinan University, Guangzhou, China.
² Department of Endocrinology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
³ Functional Examination Section, Gansu Provincial Maternity and Child-Care Hospital (Gansu Provincial Hospital), Lanzhou, China.
⁴ Clinical Experimental Center, The First Affiliated Hospital of Jinan University, Guangzhou, China.

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, p = 0.001, before propensity score matching (PSM); OR 0.792, 95% CI 0.702-0.894, p < 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.

Keywords: benign tumors; borderline tumors; cardiac-specific death; central nervous system; non-malignant tumors; radiation therapy.