Consolidation ICIs Alter cardiac subregion radiosensitivity in NSCLC patients treated with Chemo-Radiotherapy

This study evaluated cardiac subregion radiosensitivity in patients with non-small cell lung cancer (NSCLC) treated with chemoradiotherapy and consolidation immunotherapy (ICIs). In a cohort of 193 patients, comparison between ICI and non-ICI groups demonstrated that ICI administration alters subregion-specific radiosensitivity associated with cardiac toxicity. Dose-volume parameters of the left ventricle, left atrium, and whole heart were significantly associated with grade 2 or higher cardiac events. Cardiac substructure segmentation was performed using Aview (Coreline Soft), enabling automated and accurate assessment of cardiac dose through deep learning-based analysis. These findings suggest that stricter cardiac dose constraints may be required for patients receiving ICI therapy to reduce the risk of cardiac toxicity.