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Titolo:
Prospective evaluation of early cardiac damage induced by epirubicin-containing adjuvant chemotherapy and locoregional radiotherapy in breast cancer patients
Autore:
Meinardi, MT; van Veldhuisen, DJ; Gietema, JA; Dolsma, WV; Boomsma, F; van den Berg, MP; Volkers, C; Haaksma, J; de Vries, EGE; Sleijfer, DT; van der Graaf, WTA;
Indirizzi:
Univ Groningen Hosp, Dept Med Oncol, NL-9700 RB Groningen, Netherlands Univ Groningen Hosp Groningen Netherlands NL-9700 RB ningen, Netherlands Univ Groningen Hosp, Dept Cardiol, NL-9700 RB Groningen, Netherlands Univ Groningen Hosp Groningen Netherlands NL-9700 RB ningen, Netherlands Univ Groningen Hosp, Dept Radiat Oncol, NL-9700 RB Groningen, Netherlands Univ Groningen Hosp Groningen Netherlands NL-9700 RB ningen, Netherlands Erasmus Med Ctr, Dept Internal Med, Rotterdam, Netherlands Erasmus Med Ctr Rotterdam Netherlands ernal Med, Rotterdam, Netherlands
Titolo Testata:
JOURNAL OF CLINICAL ONCOLOGY
fascicolo: 10, volume: 19, anno: 2001,
pagine: 2746 - 2753
SICI:
0732-183X(20010515)19:10<2746:PEOECD>2.0.ZU;2-C
Fonte:
ISI
Lingua:
ENG
Soggetto:
ANTHRACYCLINE-INDUCED CARDIOTOXICITY; LEFT-VENTRICULAR DYSFUNCTION; ATRIAL-NATRIURETIC-PEPTIDE; CONGESTIVE-HEART-FAILURE; CORRECTED QT INTERVAL; DOXORUBICIN CARDIOTOXICITY; FOLLOW-UP; DOPPLER-ECHOCARDIOGRAPHY; SYSTOLIC DYSFUNCTION; RATE-VARIABILITY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
33
Recensione:
Indirizzi per estratti:
Indirizzo: van der Graaf, WTA Univ Groningen Hosp, Dept Med Oncol, POB 30-001, NL-9700 RB Groningen, Netherlands Univ Groningen Hosp POB 30-001 Groningen Netherlands NL-9700 RB
Citazione:
M.T. Meinardi et al., "Prospective evaluation of early cardiac damage induced by epirubicin-containing adjuvant chemotherapy and locoregional radiotherapy in breast cancer patients", J CL ONCOL, 19(10), 2001, pp. 2746-2753

Abstract

Purpose: To evaluate prospectively the cardiotoxic effects of epirubicin-containing adjuvant chemotherapy in breast cancer patients. Patients and Methods: patients (median age, 46 years; range, 28 to 55 years) were treated with five cycles of fluorouracil, epirubicin (90 mg/m(2)), and cyclophosphamide (FEC) (group 1, n = 21) or with four cycles of FEC followed by high-dose chemotherapy consisting of cyclophosphamide, thiotepa, and carboplatin (group II, n = 19). Locoregional radiotherapy was applied subsequently. Cardiac evaluation was performed before chemotherapy (T0), 1 month after chemotherapy, 1 month after radiotherapy (T2), and 1 year after start of chemotherapy (T3). Left ventricular election fraction (LVEF) was determined by radionuclide ventriculography and diastolic function by echocardiography. Autonomic function was assessed by 24-hour ECG registration for heart rate variability (HRV) analysis. Time-corrected QT (QTc) was assessed and N-terminal atrial natriuretic peptide (NT-ANP) and brain natriuretic peptide (BNP) weremeasured as biochemical markers of cardiac dysfunction. Results: No patient developed overt congestive heart failure (CHF) and themean LVEF declined from 0.61 at T0 to 0.54 at T3 (P = .001), resulting in an LVEF below 0.50 (range, 0.42 to 0.49) in 17% of the patients, whereas 28% had a decline of more than 0.10. plasma MT-ANP levels increased graduallyfrom 237 pmol/L at TO to 347 pmol/L at T3 (P < .01), whereas plasma BNP revels increased from 2.9 pmol/L to 5.1 pmol/L(P = .04). Mean QTc increased from 406 msec at T0 to 423 msec at T3 IP < .01). No persistent alterations were found in diastolic function and HRV. Conclusion: Relatively low doses of epirubicin in adjuvant chemotherapy for breast cancer results in mild subclinical myocardial damage demonstrated by a decline in LVEF, an increase in natriuretic peptide levels, and an increase in QTc, which may indicate a long-term risk of CHF. (C) 2001 by American Society of Clinical Oncology.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 04/07/20 alle ore 21:11:50