Evaluation of dexrazoxane effect on preventing acute cardiac arrhythmia in patients with breast cancer treated with neoadjuvant/adjuvant anthracycline-based chemotherapy.

INTRODUCTION: Adding dexrazoxane to the treatment during neoadjuvant/adjuvant anthracycline-based chemotherapy in patients with breast cancer prevents the development of heart failure. In this study, we investigated whether dexrazoxane has a protective effect on arrhythmia resulting from chemotherapy. METHODS: Patients with breast cancer who received neoadjuvant/adjuvant anthracycline-based chemotherapy in the medical oncology polyclinic between 2017 and 2020 were included in the study. To investigate the effect of dexrazoxane on arrhythmia, this retrospective study included 70 patients, whose 12-lead surface electrocardiograms (ECGs) and echocardiography were obtained before receiving anthracycline-based treatment and after receiving four cycles of chemotherapy. Thirty-two patients received anthracycline only, and 38 patients received anthracycline and dexrazoxane. Arrhythmia parameters such as QT interval, QTc interval, Tp-e interval, Tp-e/QT, Tp-e/QTc and frontal QRS-T angle were calculated from 12-lead ECGs. RESULTS: Arrhythmia parameters such as frontal QRS-T angle , QT , QTc and heart rate were significantly increased after chemotherapy in both the groups that received dexrazoxane and did not receive dexrazoxane (P < .05). Contrary to the ECG parameters, ejection fraction was decreased in the dexrazoxane group (60.5 ± 2.2 vs 60.1 ± 2.0; P = .038) and the other group (60.4 ± 1.3 vs 60.0 ± 2.6; P = .043) after the chemotherapy. CONCLUSION: This study demonstrated that dexrazoxane may not have a protective effect on ECG parameters which are predictors of arrhythmia, at breast cancer patients who received anthracyclines.

Factors affecting the response to treatment and survival in hepatocellular carcinoma patients treated with transarterial radioembolisation: a single-centre experience.

OBJECTIVE: Transarterial radioembolisation (TARE) is a promising technique for unresectable primary tumours of the liver. We present our clinical experience and the response to treatment and survival data of patients with hepatocellular carcinoma (HCC) who were treated with Y-90 radioembolisation in our hospital's angiography department. MATERIAL AND METHODS: The data of all the patients with HCC referred to our department for Y-90 treatment were analysed retrospectively. The patients were selected according to the treatment protocol criteria, and lung shunt fraction was evaluated using macroaggregated albumin scintigraphy before radioembolisation. Patients with compatible blood tests and lung shunt fraction rates were chosen for treatment with Y-90 TARE. RESULTS: Twenty-four patients were suitable for Y-90 treatment. The patients were treated with 137 ± 44.6 (80-245) Gy Y-90 glass microspheres. The treatment results were evaluated using modified RECIST criteria, and the partial response, complete response, stable disease and progression rates were found to be 54.2, 16.7, 20.8 and 8.3%, respectively. The median survival rate following treatment was 10 months. Higher alpha-fetoprotein (AFP) levels were related to decreased survival, and posttreatment AFP levels had a significant effect on mortality rates. Higher survival rates were detected in the patients who were treated more selectively than the group treated via a lobar approach. CONCLUSION: Y-90 microsphere radioembolisation is a safe method and may be helpful in treating patients with unresectable hepatocellular tumours. More favourable results were obtained in the patients treated using the more selective approach. AFP levels before and after treatment could predict survival rates.

Survival and prognostic factors in patients with brain metastasis: Single center experience.

PURPOSE: The purpose of this study was to evaluate the clinical status, prognostic factors and treatment modalities affecting survival in patients with brain metastasis. We aimed to evaluate the whole brain radiation therapy (WBRT) outcomes of patients with brain metastasis in our center. METHODS: Clinical data of 315 patients referred to our center between 2004 and 2014 with metastatic brain cancers were collected and analysed for possible relationships between survival time, age, gender, Karnofsky performance status (KPS), recursive partitioning analysis (RPA), primary tumor, number of brain lesions, surgery, radiation therapy scheme, extracranial metastatic status and primary disease control status. RESULTS: The average patient age of onset was 58 years. The primary tumor site was lung (68%), breast (12%), melanoma (4%), colorectal (1.6%), sarcoma (1.3%) and unknown primary disease (4.4%). The rest of the patients had other primary sites. Eighty four (26.6%) patients had single brain metastasis, 71 (22.5%) had 2 or 3 lesions, and 159 (50.4%) patients had more than 3 lesions. Leptomeningeal involvement was seen in combination of paranchymal involvement in 11 (3.5%) patients. Fifty patients had undergone surgical resection. WBRT was delivered to all of the patients. Median overall survival was 6.7 months (95% CI, 5.80-7.74). Median overall survival of patients treated with combination of surgery and WBRT was significantly better compared with those treated with WBRT alone (13.5 vs 5.5 months, p=0.0001). One- and 2- year survival was 17 and 4.7%, respectively. CONCLUSIONS: The present study concludes that brain metastasis is common in cancer patients. The best overall survival was obtained by surgery+NBRT in good-condition patients. Treatment should be tailored on an individual basis to all these patients.