Key result
Doxorubicin-based chemotherapy and chest wall irradiation resulted in an 18% incidence of subclinical cardiac dysfunction and a significant decline in mean left ventricular ejection fraction.
Why the study?
To evaluate cardiac functions in left-sided postmastectomy breast cancer patients receiving doxorubicin-based chemotherapy with chest wall irradiation.
Does doxorubicin-based chemotherapy and chest wall irradiation cause subclinical cardiac dysfunction in left-sided breast cancer patients?
Observational (n=55)
No
Does doxorubicin-based chemotherapy and chest wall irradiation cause subclinical cardiac dysfunction in left-sided breast cancer patients?
Doxorubicin-based chemotherapy and chest wall irradiation in left-sided breast cancer patients lead to mild but statistically significant subclinical echocardiographic changes, with an 18% incidence of cardiotoxicity at 6 months post-radiation.
May warrant closer LVEF surveillance after doxorubicin plus chest radiation; leaves open optimal prevention strategies.
This prospective single institution study was carried out with 55 patients to evaluate the cardiac functions in left sided post mastectomy breast cancer patients who received Doxorubicin based chemotherapy with chest wall irradiation. Our study reported only 18% cardiotoxicity in contrast to about 30% in similar studies. There was a decline in the left ventricular ejection fraction after chemotherapy. Radiation did not affect left ventricular function much. The right ventricular systolic dysfunction observed in our study, as depicted by the value of TAPSE decreased after chemotherapy and then after radiation. Neither age nor the use of Taxanes following Doxorubicin administration factored much. The mean cumulative dose of Doxorubicin was confined to 360 mg/m2. Radiation induced cardiac dysfunction was mainly confined to the changes in the dimensions of the ventricles and left atrium volume. Decreased cardiotoxicity observed was probably due to short follow up of 6 months.
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Kamei et al. (2020) conducted an observational in Left-sided breast cancer (n=55). Doxorubicin-based chemotherapy and chest wall irradiation vs. Baseline was evaluated on Left ventricular ejection fraction (LVEF) (p=0.000). Doxorubicin-based chemotherapy and chest wall irradiation resulted in an 18% incidence of subclinical cardiac dysfunction and a significant decline in mean left ventricular ejection fraction.
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