Browsing by Subject "Radiation dosage"

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    Introduction to the Special LDLensRad Focus Issue
    (BioOne, 2022) Ainsbury, Elizabeth A.; Dalke, Claudia; Mancuso, Mariateresa; Kadhim, Munira; Quinlan, Roy A.; Azizova, Tamara; Dauer, Lawrence T.; Dynlacht, Joseph R.; Tanner, Rick; Hamada, Nobuyuki; Radiation Oncology, School of Medicine
    Recent epidemiological and experimental animal data, as well as reanalyses of data previously accumulated, indicate that the lens of the eye is more radiosensitive than was previously thought. This has resulted in a reduction of the occupational lens dose limit within the European Union countries, Japan and elsewhere. This Commentary introduces the work done by the LDLensRad Consortium contained within this Focus Issue, towards advancement of understanding of the mechanisms of low dose radiation cataract.
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    Statin Use, Heart Radiation Dose, and Survival in Locally Advanced Lung Cancer
    (Elsevier, 2021) Atkins, Katelyn M.; Bitterman, Danielle S.; Chaunzwa, Tafadzwa L.; Williams, Christopher L.; Rahman, Rifaquat; Kozono, David E.; Baldini, Elizabeth H.; Aerts, Hugo J. W. L.; Tamarappoo, Balaji K.; Hoffmann, Udo; Nohria, Anju; Mak, Raymond H.; Medicine, School of Medicine
    Purpose: Patients with locally advanced non-small cell lung cancer (LA-NSCLC) have a high prevalence of pre-existing coronary heart disease and face excess cardiac risk after thoracic radiation therapy. We sought to assess whether statin therapy is a predictor of overall survival (OS) after thoracic radiation therapy. Methods and materials: We performed a retrospective analysis of 748 patients with LA-NSCLC treated with thoracic radiation therapy, using Kaplan-Meier OS estimates and Cox regression. Results: Statin use among high cardiac risk patients (Framingham risk ≥20% or pre-existing coronary heart disease; n = 496) was 51.2%. After adjustment for baseline cardiac risk and other prognostic factors, statin therapy was associated with a significantly increased risk of all-cause mortality (adjusted hazard ratio, 1.39; 95% confidence interval [CI], 1.00-1.91; P = .048) but not major adverse cardiac events (adjusted hazard ratio, 1.18; 95% CI, 0.52-2.68; P = .69). Among statin-naïve patients, mean heart dose ≥10 Gy versus <10 Gy was associated with a significantly increased risk of all-cause mortality (hazard ratio, 1.32; 95% CI, 1.04-1.68; P = .022), with 2-year OS estimates of 46.9% versus 60.0%, respectively. However, OS did not differ by heart dose among patients on statin therapy (hazard ratio, 1.00; 95% CI, 0.76-1.32; P = 1.00; P-interaction = .031), with 2-year OS estimates of 46.9% versus 50.3%, respectively. Conclusions: Among patients with LA-NSCLC, only half of statin-eligible high cardiac risk patients were on statin therapy, reflecting the highest cardiac risk level of our cohort. Statin use was an independent predictor of all-cause mortality but not major adverse cardiac events. Elevated mean heart dose (≥10 Gy) was associated with increased risk of all-cause mortality in statin-naïve patients but not among those on statin therapy, identifying a group of patients in which early intervention with statins may mitigate the deleterious effects of high heart radiation therapy dose. This warrants evaluation in prospective trials.