Cardiovascular risk of anthracyclines in treatment of breast cancer and its strategy / 肿瘤研究与临床

ABSTRACT

Objective To evaluate the clinical cardiovascular reverse reactions of the patients with breast cancer who received chemotherapy with anthracyclines. Methods Two hundred and ninety-one cases of breast cancer who were treated with pirarubicin (40 mg/m2) + docetaxel (75 mg/m2) in Shanxi Provincial Cancer Hospital from January 2014 to December 2016 were collected. The changes of electrocardiogram (ECG), echocardiography and myocardial enzyme were recorded before and after chemotherapy. Results Before chemotherapy, there were 14 patients (4.8 %) with ST-T segment changes before ECG, 6 patients (2.1 %)with atrial extrasystole,8 patients(2.7 %)with ventricular extrasystole.After chemotherapy,cases with abnormal ECG were 62 (21.4 %), 47 (16.2 %) and 52 (17.9 %) respectively. The difference between the two groups was statistically significant (χ2= 6.249, P < 0.005). The average left ventricular ejection fraction after chemotherapy was significantly lower than that before chemotherapy (0.72±0.10 vs. 0.81±0.18, t= 3.480, P <0.05). The levels of creatine kinase (CK), aspartate aminotransferase (AST) and creatine kinase CK (CK-MB) were (68±20), (35±13) and (15.1±4.0) U/L after chemotherapy respectively, which were significantly higher than those before chemotherapy [(50 ±12), (28 ±12) and (7.9 ±2.6) U/L], the differences were statistically significant (t values were 9.721, 5.137 and 18.850 respectively, all P < 0.005). Conclusion The use of anthracyclines results in the increased risk of ECG abnormalities and myocardial damage in patients with breast cancer,and cardiac dynamic monitoring should be noted during chemotherapy.