High-dose radiotherapy in patients with locally advanced non-small cell lung cancer can lead to development of serious cardiac complications and increased mortality, a study suggests.

In a cohort of 748 US patients, over a median follow-up of more than 20 months, 77 patients developed at least one major adverse cardiac event, yielding a two-year cumulative incidence of 5.8%, the researchers said. During this period, 533 of the patients died.

Patients without pre-existing coronary heart disease (CHD) who received a radiation dose of more than 10Gy had a 34% increased risk of all-cause mortality than those receiving lower doses, they found.

“We found that higher doses of cardiac radiation exposure during lung-cancer radiotherapy are associated with the development of serious cardiac complications such as heart attacks and death,” said Dr Katelyn Atkins, from the Dana-Farber Cancer Institute and Brigham and Women’s Hospital in Boston.