Keeping the Heartbeat Off-Target in Cancer Therapy
Menée aux Etats-Unis à partir de données 2010-2020 portant sur 6 881 patients adultes atteints d'un cancer, cette étude de cohorte rétrospective analyse l'association entre la formule de l'intervalle QTc utilisée (formule de Bazett, Framingham ou Fridericia) et le degré de sévérité des événements indésirables associés à la chimiothérapie
The field of cardio-oncology and the management of cardiac conditions in patients receiving chemotherapy, radiation therapy, and immunotherapy have grown in importance as more treatment options become available, survival from cancer improves, and the general population ages.1 Most research in this area to date has been focused on the effects of cancer therapy on the working myocardium, leading to changes in ejection fraction, and on the cell layers comprising the coronary arteries, with resultant premature ischemic heart disease. In contrast, in this issue of JAMA Oncology, 2 cohort studies focus on quantifying the association of cancer therapies with elements of the cardiac conduction system and with the electrocardiographic manifestation of myocardial repolarization, each critical for the maintenance of normal cardiac rhythm. Kim et al2 investigated the outcomes of mediastinal radiation therapy for small cell lung cancer (SCLC) and non–small cell lung cancer (NSCLC) by estimating radiation doses to the sinoatrial node (SAN) and neighboring substructures and report the association with new-onset atrial fibrillation (AF) and mortality in both populations. In the article by Richardson and colleagues,3 the clinical consequences of the formulae used to correct the QT interval for heart rate, a key determinant of ventricular proarrhythmia, were evaluated in a large cohort of patients receiving chemotherapy.
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JAMA Oncology , éditorial, 2021