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Cardiac Imaging and Diagnostics / Cerebrovascular and Carotid Artery Diseases / Chemotherapy-induced Cardiotoxicity and Mitigation · Journal article
Cardio-oncology · August 18, 2026
Early or partial results. Treat as a signal, not a conclusion.
This retrospective analysis of 26 patients with stage 3B NSCLC found that chemoradiotherapy was associated with a 10% increase in aortic calcium score and a 4% increase in aortic [18F]FDG uptake over approximately 14 weeks, suggesting possible accelerated atherosclerotic disease activity. The findings are based on imaging biomarkers in a small cohort without a control group and do not establish clinical cardiovascular harm.
Retrospective cohort study with repeated imaging biomarker assessment. Patients with stage 3B NSCLC from the ACRIN 6668 trial with available pre- and post-treatment [18F]FDG PET-CT imaging; mean age 60 ± 9 years, mean BMI 25 ± 5 kg/m².. Intervention: Chemoradiotherapy for advanced (stage 3B) NSCLC. n = 26. Data sourced from the Cancer Imaging Archive (ACRIN 6668 trial); specific trial centres not stated in abstract..
Aortic calcium score increased by 10% after chemoradiotherapy (p < 0.05) Aortic [18F]FDG TBR mean uptake increased by 4% after chemoradiotherapy (p = 0.02) 23 of 26 patients (88%) had aortic atherosclerosis evidenced by aortic calcification
Safety was not reported in the material analysed. Check the source before drawing any conclusion about harm.
These findings raise concern about cardiovascular toxicity from chemoradiotherapy in lung cancer survivors but remain at the level of imaging biomarkers. Clinicians should recognize this signal as preliminary evidence supporting closer cardiovascular surveillance and risk factor management in NSCLC survivors, pending confirmation in prospective studies with hard clinical outcomes.
A small single-centre imaging study with surrogate endpoints (calcium score and FDG uptake) showing a signal of chemoradiotherapy-associated aortic atherosclerosis progression, but lacking hard clinical outcomes and requiring confirmation.
As stated by the source record.
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These findings raise concern about cardiovascular toxicity from chemoradiotherapy in lung cancer survivors but remain at the level of imaging biomarkers. Clinicians should recognize this signal as preliminary evidence supporting closer cardiovascular surveillance and risk factor management in NSCLC survivors, pending confirmation in prospective studies with hard clinical outcomes.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Abstract Background Cardiovascular and pro-atherogenic side-effects of chemoradiotherapy for non-small cell lung cancer (NSCLC) remain a major concern given the growing burden of cancer therapy-related cardiovascular disease. Atherosclerotic plaque burden can be measured using calcium scoring while plaque activity can be assessed using [ 18 F]fluorodeoxyglucose ([ 18 F]FDG) positron emission tomography (PET). Objectives To investigate the impact of chemoradiotherapy on aortic atherosclerotic burden and disease activity in patients with advanced NSCLC undergoing repeated [ 18 F]FDG PET and computed tomography (CT) scans. Methods All [ 18 F]FDG PET-CT scans of patients with stage 3B NSCLC from the American College of Radiology Imaging Network (ACRIN 6668) trial were retrieved from the Cancer Imaging Archive. Volumes of interest for the aorta, left ventricle and major non-cardiac organs were manually delineated. Calcium scores, mean standard uptake values (SUV mean ) and target-to-background ratios (TBR mean ) were quantified, and comparisons before and after treatment scans performed. Results Twenty-six patients (mean 60 ± 9 years, body-mass index 25 ± 5 kg/m 2 ) met the inclusion criteria, with 23 having aortic atherosclerosis as evidenced by the presence of aortic calcification. Pre- and post-treatment scans were performed approximately 14 weeks apart. After chemoradiotherapy, aortic calcium score increased by 10% in calcified plaques ( p < 0.05) and aortic [ 18 F]FDG TBR mean uptake increased by 4% ( p = 0.02). There were no changes in [ 18 F]FDG uptake in other organs. Conclusion Chemoradiotherapy has adverse effects on the vasculature, possibly through increased inflammation resulting in accelerated atherosclerotic disease. This increased cardiovascular risk in lung cancer survivors highlight the need for aggressive risk factor modification at the earliest opportunity.
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