Investigation of the efficacy of the change ratio of brain natriuretic peptide for predicting the cardiac effects of chemoradiotherapy on esophageal cancer

Hatayama,Yoshiomi; Kudo,Shiori; Ota,Riko; Kuroki,Akane; Tanaka,Mitsuki; Yotsuya,Chihiro; Ichise,Koji; Fujioka,Ichitaro; Sato,Mariko; Kawaguchi,Hideo; Aoki,Masahiko

doi:10.3892/ol.2023.14026

Investigation of the efficacy of the change ratio of brain natriuretic peptide for predicting the cardiac effects of chemoradiotherapy on esophageal cancer

Authors:
- Yoshiomi Hatayama
- Shiori Kudo
- Riko Ota
- Akane Kuroki
- Mitsuki Tanaka
- Chihiro Yotsuya
- Koji Ichise
- Ichitaro Fujioka
- Mariko Sato
- Hideo Kawaguchi
- Masahiko Aoki
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Affiliations: Department of Radiation Oncology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori 036‑8562, Japan, Hirosaki University School of Medicine, Hirosaki, Aomori 036‑8562, Japan, Department of Internal Medicine, Kodomari Clinic, Kitatsugaru‑gun, Aomori 037‑0512, Japan, Department of Radiation Oncology, Sumitomo Hospital, Osaka, Osaka 530‑0005, Japan, Department of Radiation Oncology, Southern Tohoku BNCT Research Center, Koriyama, Fukushima 963‑8563, Japan
Published online on: August 23, 2023 https://doi.org/10.3892/ol.2023.14026
Article Number: 439
Copyright: © Hatayama et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The aim of this study was to investigate the effectiveness of brain natriuretic peptide (BNP) as a predictor of radiological effects on the heart. A total of 41 patients with esophageal cancer who underwent chemoradiotherapy (CRT) were retrospectively investigated. The BNP levels were measured on the first day of CRT (pre‑CRT) and the last day of CRT (post‑CRT), and the median concentration of BNP and dosimetric parameters of the heart were calculated. The change ratio of BNP was calculated as follows: [(BNP post‑CRT) - (BNP pre‑CRT)]/(BNP pre‑CRT). The comparison of BNP pre‑CRT with post‑CRT was performed using a Wilcoxon signed‑rank test. The relationship between dosimetric parameters and change ratio was analyzed using Spearman's correlation coefficient. The median levels of BNP of pre‑CRT and post‑CRT were 10 and 22 pg/ml, respectively, and the difference was statistically significant (P<0.0001). Significant correlations (all P<0.05) were observed between the change ratio and mean dose, V5, V10, V20, and V30. Of the cohort, 14 patients developed acute‑to‑subacute cardiac events, such as pericardial effusion, cardiomegaly, acute exacerbation of chronic heart failure, and a decreased ejection fraction. The change ratios of BNP, V5, V10, V20, and V30 were significantly higher in patients who experienced cardiac events compared with those who did not. The results of this study showed that BNP measurement, particularly the change ratio of BNP pre‑ and post‑CRT, may be a useful cardiac event predictor in addition to dosimetric parameters.

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