Positive association between heart dosimetry parameters and a novel cardiac biomarker, solubleST-2, in thoracic cancer chest radiation

J Clin Lab Anal. 2020 Apr;34(4):e23150. doi: 10.1002/jcla.23150. Epub 2020 Jan 10.

Abstract

Background: Early screening and diagnosis of radiation-induced heart disease (RIHD) is difficult in patients with chest radiation exposure. sST-2 is involved in myocardial stress or injury. We evaluated the relationship between heart dose parameters and sST-2 changes in chest malignant tumor patients who received chest radiation.

Methods: We prospectively collected thoracic malignancy cancer patients who had received chest radiotherapy. Heart dosimetry parameters were extracted from the treatment planning system. sST-2 was measured at baseline, the middle stage, and after radiotherapy (recorded as pre-ST-2, mid-ST-2, and post-ST-2). sST-2 change rate was calculated. Scatter plots showed the relationship between cardiac dose parameters and ST-2 change rate. Multiple regression was used to analyze the relationship between cardiac dose parameters and ST-2 change rate.

Results: Totally, 60 patients were enrolled. The mean V5 , V10 , V20 , V30 , V40 , and MHD was 60.93 ± 27.79%, 51.43 ± 25.44%, 39.17 ± 21.75%, 28.07 ± 17.15%,18.66 ± 12.18%, and 18.60 ± 8.63 Gy, respectively. The median M-LAD was 11.31 (IQR 3.33-18.76) Gy. The mean pre-ST-2, mid-ST-2, and post-ST-2 was 5.1 ± 3.8, 6.4 ± 3.9, and 7.6 ± 4.4, respectively. sST-2 was elevated with thoracic irradiation (P < .001). Multivariate linear regression analyses showed that V5 , V10 , V20 , and MHD were independently and positively associated with ST-2 change rate (β = .04, .04, .04, and .10, respectively, all P < .05).

Conclusion: Serum sST-2 levels were elevated over time during radiotherapy. V5 , V10 , V20 and MHD were independently and positively associated with the elevated ST-2 change rate.

Keywords: cardiac biomarker; heart dosimetry parameters; radiation-induced heart disease; radiotherapy; sST-2.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers / metabolism
  • Dose-Response Relationship, Radiation
  • Female
  • Heart / physiopathology
  • Heart / radiation effects*
  • Humans
  • Interleukin-1 Receptor-Like 1 Protein / blood
  • Interleukin-1 Receptor-Like 1 Protein / metabolism*
  • Male
  • Middle Aged
  • Natriuretic Peptide, Brain / blood
  • Radiometry*
  • Solubility
  • Stroke Volume
  • Thoracic Neoplasms / blood
  • Thoracic Neoplasms / radiotherapy*

Substances

  • Biomarkers
  • IL1RL1 protein, human
  • Interleukin-1 Receptor-Like 1 Protein
  • Natriuretic Peptide, Brain