Biomarker Testing to Predict Radiation-Related Heart Disease in Lung Cancer Patients

The study will measure serum Pro-N-Cadherin and NT-proBNP (pro B-type natriuretic peptide) levels in adults with non-small cell lung cancer receiving hypofractionated radiation therapy and evaluate whether these biomarkers correlate with radiation dose to the heart, cardiac dysfunction, and adverse cardiac events. Participants will undergo blood collection and echocardiography over a two-year follow-up period.

Inclusion Criteria: * ≥ 18 years of age * Histologic documentation or clinical suspicion of non-small cell lung cancer based on pathology or imaging. * Location of disease must be either a central right-sided tumor (defined as tumors with a planning target volume within 2 cm of the primary airways) arising below the level of the heart or any left-sided tumor arising below the level of the heart. * Planned to receive hypofractionated radiation therapy (4-18 Gy fractions to a total dose of 45-70 Gy) * Planning the target volume that is at or below the most superior aspect of the heart. * Willing and able to provide written informed consent Exclusion Criteria: * Planning to receive concurrent or sequential chemotherapy or immunotherapy * Prior radiation therapy to the chest that included more than a minimal dose to the heart (\> 1 Gy mean dose).