Bad LAD.

Top Line: Does mean heart dose adequately predict the risk of adverse events associated with cardiac sub-structures?

The Study: A recent analysis of cardiac dose in >700 patients receiving thoracic radiation for NSCLC found a significant increase in the risk of major adverse cardiac events (MACE) when the left anterior descending artery (LAD) V15 was 10% or higher. While the paper described optimal dosimetric thresholds for other cardiac sub-structures, LAD V15 was independently associated with the risk of MACE. This follow-up analysis from the same group sought to determine if mean heart dose (MHD) is a good surrogate for LAD V15--because let’s be honest, there are fewer residents in the pipeline to contour cardiac sub-structures. Patients were categorized as having 1) high MHD (>10 Gy) and high LAD V15 (>10%), 2) high MHD, low LAD V15, 3) low MHD, high LAD V15, and 4) low MHD, low LAD V15. Most patients had concordant high/high (44%) or low/low (33%) dosimetry while 14% had high MHD/low V15 and 9% had low MHD/high V15. Patients with a low LAD V15 had significantly lower risk of MACE than those with high LAD V15--regardless of whether they had a high or low MHD. Put another way, patients with a low MHD but a high LAD V15 had a higher risk of MACE at 2-years (13%) than those with a high MHD but low LAD V15 (4.2%).

TBL: The left anterior descending artery V15 +/- 10% is associated with MACE risk after thoracic radiation, and mean heart dose is a poor surrogate for LAD V15. | Atkins, Int J Radiat Oncol Biol Phys 2021

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  31. LESEN SIE MEIN ZEUGNIS, WIE ICH MEIN DARLEHEN VON EINER ECHTEN UND ECHTEN DARLEHENFIRMA namens JOSE LUIS LOANS ERHALTEN HABE, ICH BIN HEUTE SEHR GLÜCKLICH UND GOTT SEGNET JOSE LUIS LOAN

    Hallo,
    Mein Name ist Maria, von der ich komme, bin verheiratet, ich habe in den letzten 5 Monaten nach einer echten Kreditfirma gesucht und alles, was ich bekommen habe, waren eine Reihe von Betrügereien, die mich dazu gebracht haben, ihnen zu vertrauen, und am Ende des Tages nahmen sie mein Geld, ohne etwas zurückzugeben, all meine Hoffnung war verloren, ich war verwirrt und frustriert, es fällt mir sehr schwer, meine Familie zu ernähren, ich wollte nie etwas mit Kreditunternehmen im Internet zu tun haben, also ging ich zu Krediten etwas Geld von a
    Freund, ich habe ihr alles erzählt, was passiert ist und sie sagte, dass sie mir helfen kann, dass sie eine Kreditfirma kennt, die mir mit jedem von mir benötigten Kreditbetrag mit einem sehr niedrigen Zinssatz von 2% helfen kann, dass sie gerade einen Kredit bekommen hat Von ihnen wies sie mich an, wie ich das Darlehen beantragen soll, ich habe genau das getan, was sie mir gesagt hat, ich habe mich per E-Mail bei ihnen beworben: (joseluisloans@gmail.com), ich habe es nie geglaubt, aber ich habe es versucht und zu meiner größten Überraschung bekam ich das Darlehen innerhalb von 24 Stunden, ich konnte es nicht glauben,
    Ich bin glücklich und wieder reich und ich danke Gott, dass es solche Kreditfirmen noch immer gibt, wenn es um diese Betrügereien geht
    (joseluisloans@gmail.com) Sie werden dich nie im Stich lassen und dein Leben wird sich so ändern wie meines. Wenden Sie sich noch heute schnell an Jose Luis Darlehen und holen Sie sich Ihr Darlehen von ihnen, Gott segne Jose Luis
    Unternehmen für ihr echtes Kreditangebot.
    Stellen Sie sicher, dass Sie sich für Ihr Darlehen an die Firma Jose Luis wenden, da ich mein Darlehen ohne Stress erfolgreich von dieser Firma erhalten habe

    ReplyDelete
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