Early Specialized Cardiovascular Intervention Based on Impedance Cardiography in Locally Advanced Non-small Cell Lung Cancer Patients
Non-small Cell Lung Cancer, Cardiovascular Complication
About this trial
This is an interventional treatment trial for Non-small Cell Lung Cancer focused on measuring Non-small Cell Lung Cancer, Cardiovascular Intervention, Impedance Cardiography, Cardiovascular Event
Eligibility Criteria
Inclusion Criteria:
- It is diagnosed as non-small cell lung cancer by pathological examination or cytological examination; it is assessed as locally advanced, unresectable stage III non-small cell lung cancer by imaging;
- Plan to receive radical radiotherapy and chemotherapy ± immunotherapy;
- Male or female between 18 and 75 years old;
- Life expectancy ≥ 12 weeks;
- The World Health Organization (WHO) PS score is 0 or 1;
- Organ and bone marrow function meet the following conditions: Forced expiratory volume per second (FEV1) ≥1000 ml; absolute neutrophil count ≥1.5×10^9/L; platelets ≥100×10^9/L; hemoglobin ≥90 g/L ; Serum creatinine clearance calculated according to the Cockcroft-Gault formula ≥50 mL/min (Cockcroft and Gault 1976); serum bilirubin ≤1.5 times the upper limit of normal (ULN); alanine aminotransferase and aspartate aminotransferase ≤2.5 times ULN;
- A signed informed consent form is required before proceeding with any step in the research;
- There is an abnormality in the initial cardiac output index.
Exclusion Criteria:
- PS score 2-4;
- Organ function impairment: FEV1 <1000ml; absolute neutrophil count <1.5×10^9/L; platelets <100×10^9/L; hemoglobin <90 g/ L; Serum creatinine clearance calculated according to Cockcroft-Gault formula <50 mL/min; serum bilirubin>1.5 times ULN; alanine aminotransferase and aspartate aminotransferase>2.5 times ULN;
- Unstable angina or myocardial infarction occurred in the past month;
- Arrhythmia that has not been controlled and can cause symptoms or abnormal hemodynamics;
- Active endocarditis;
- Symptomatic severe aortic stenosis;
- Heart failure that has not been controlled;
- Acute pulmonary embolism, pulmonary infarction or low thrombosis (artery or vein) formation;
- Suspected or confirmed aortic dissection;
- Uncontrolled bronchial asthma;
- Pulmonary edema;
- Fingertip blood oxygen saturation at rest ≤85%;
- Acute non-cardiopulmonary diseases (such as infection, renal failure, thyrotoxicosis, etc.) that may affect sports performance or aggravate due to exercise;
- Mental disorders make it impossible to cooperate.
Sites / Locations
- Sun yat-sen University Cancer CenterRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
No Intervention
The early intervention group
The control group
The early intervention group: evaluation and intervention based on impedance cardiography results at multiple timepoints. Specific intervention measures include: cardiovascular drug treatment: based on the increase and decrease of the "Golden Triangle" ACEI, perindopril tert-butyrate 4mg qd β receptor antagonist, metoprolol succinate 47.5mg qd Spironolactone 20mg qd Drugs to improve myocardial metabolism: trimetazidine hydrochloride 35 mg bid Other therapeutic drugs include: loop diuretics, ARNI, sinus node If current selection specific inhibitors, statins, antiplatelet aggregation and nitrate drugs, etc. Exercise intervention: exercise prescription based on the initial cardiopulmonary exercise test results.
This group will be under observation. When cardiovascular events (including ischemic cardiomyopathy, heart failure, arrhythmia requiring treatment, pericardial disease requiring treatment, valvular disease, etc.) happen, a cardiovascular specialist assessment and intervention will be given.