Impact of radiotherapy on cardiovascular disease mortality in patients with different gastrointestinal malignant tumors
Xuan Changbo
Wu Huanlin
Niu Jialong
Zhao Yicong
Liu Yingchu
Liu Xiaoli
Han Hongya
Abstract：Objective To investigate the impact of radiotherapy on cardiovascular disease mortality in patients with different gastrointestinal malignant tumors.Methods A total of 621 324 patients with gastrointestinal malignant tumors were screened from the large cohort of the Surveillance,Epidemiology,and End Results database of the National Cancer Institute.Poisson regression analysis and Fine-Gray competing risk regression analysis were used to evaluate the impact of radiotherapy on cardiovascular disease mortality in patients with different gastrointestinal malignant tumors.Subgroup analysis was conducted simultaneously to identify the predictive factors of radiotherapy-related cardiovascular disease mortality.Results A total of 621 324 patients with gastrointestinal malignant tumors were enrolled,including 30 453 cases(4.9％)of esophageal cancer,53 282 cases(8.6％)of gastric cancer,452 464 cases(72.8％)of colorectal cancer,37 630 cases(6.1％)of hepatocellular carcinoma,7 979 cases(1.3％)of gallbladder cancer,and 39 516 cases(6.3％)of pancreatic cancer.Among the 106 110 patients with gastrointestinal tumors who received radiotherapy,the risk of cardiovascular disease mortality was significantly increased in patients with esophageal cancer and gastric cancer[relative risk(RR)=1.15,95％confidence interval(CI)=1.03-1.28,adjusted hazard ratio(HR)=1.15,95％CI=1.06-1.29;RR=1.19,95％CI=1.08-1.31,adjusted HR=1.11,95％CI=1.02-1.21].Compared with the general population in the United States,patients with esophageal cancer who received radiotherapy had the highest standardized mortality ratio of cardiovas-cular disease mortality.Advanced age,long disease course,male gender,and concurrent chemotherapy were associated with a higher risk of cardiovascular mortality.Conclusions Among patients with gastrointestinal malignant tumors,those with esophageal cancer and gastric cancer who receive radiotherapy have an increased risk of cardiovascular disease mortality.Advanced age,long disease course,male gender,and concurrent chemotherapy may be potential predictive factors for radiotherapy-related cardiovascular disease mortality in patients with gastroin-testinal malignant tumors.
Keywords：Gastrointestinal malignant tumorsSEER databaseCardiovascular disease mortalityRadiotherapy
Publication Date：2026-02-18
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：6( 177-182 )