To assess the clinical utility of Radiation Oncology patient referrals to a CardioOncology service.
GenesisCare (an Australian Oncology and Cardiology healthcare organisation) has established a pilot pathway in South Australia for patients undergoing thoracic radiotherapy to be referred to a CardioOncology service as part of comprehensive approach to the management of potentially cardiotoxic cancer therapy.
Medical records of the patients referred in the preceding 12 month period to 30th June 2020 were reviewed to identify clinically relevant matters found that led to a change in management.
51 patients were referred to the CardioOncology service by 8 Radiation Oncologists.
The majority of patients referred were females with left sided breast cancer, although some patients with lung cancer, oesophageal cancer and lymphoma were referred.
Of the 51 patients referred, 28 patients (55%) had previously unrecognised or untreated findings that led to change in management (with some patients having multiple pathologies):
|
Numbers of Patients |
Clinical Findings |
|
18 |
Coronary Artery Calcification on planning CT |
|
17 |
Hyperlipidaemia |
|
7 |
Hypertension |
|
3 |
Cardiac Valvular Abnormality |
|
3 |
Cardiac Arrhythmia |
|
1 |
Thoracic Aortic Dilatation |
|
1 |
Microvascular Angina |
|
1 |
Lung Nodule |
The routine referral of patients undergoing potentially cardiotoxic radiotherapy to a CardioOncology service leads to the detection and treatment of clinically relevant findings in a significant number of patients, 55%, in the immediate to short term. Some of these findings are also highly relevant to longer term cardiovascular risk, such as coronary artery calcification, hypertension and hyperlipidaemia. Others are incidental findings not related to radiotherapy risk but are nonetheless clinically relevant.