The combination of doxorubicin and thoracic radiation may synergistically induce severe cardiotoxicity even at cumulative doxorubicin doses below the traditionally safe threshold of 500 mg/m2.
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May indicate synergistic cardiotoxicity with doxorubicin plus thoracic radiation below 500 mg/m2; hypothesis-generating and requires prospective confirmation.
Comments1 January 1975Adriamycin and Radiation: Synergistic CardiotoxicityJOHN MERRILL, M.D., F. ANTHONY GRECO, M.D., HARVEY ZIMBLER, M.D., HARMAR D. BRERETON, M.D., JOHN D. LAMBERG, M.D., THOMAS C. POMEROY, M.D.JOHN MERRILL, M.D.Search for more papers by this author, F. ANTHONY GRECO, M.D.Search for more papers by this author, HARVEY ZIMBLER, M.D.Search for more papers by this author, HARMAR D. BRERETON, M.D.Search for more papers by this author, JOHN D. LAMBERG, M.D.Search for more papers by this author, THOMAS C. POMEROY, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-82-1-122_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Severe cardiomyopathy with irreversible congestive heart failure from adriamycin is very rare if the dose is limited to below 500 to 550 mg/m2 body surface area (1, 2). We have seen two patients who developed severe cardiac failure after receiving less than 500 mg/m2 body surface area of adriamycin in conjunction with therapeutic radiation to the thoracic spine and lungs. This seems to be a variable in the development of adriamycin cardiotoxicity.CASE 1An 11-year-old girl with Ewing's sarcoma of the right ilium metastatic to the skull and thoracic spine has been treated since 1972 with...References1. LEFRAKPITHAROSENHEIM EJS: A clinicopathologic analysis of adriamycin cardiotoxicity. Cancer 32:302-314, 1973 CrossrefMedlineGoogle Scholar2. BLUMCARTER RS: Adriamycin. A new anticancer drug with significant clinical activity. Ann Intern Med 80:249-259, 1974 LinkGoogle Scholar3. COHNSTEWARTFAJARDO KJL: Heart disease following radiation. Medicine (Baltimore) 46(3):281-298, 1967 CrossrefGoogle Scholar4. ROSENWOLLNERTAN GNC: Disease-free survival in children with Ewing's sarcoma treated with radiation therapy and adjuvant four-drug sequential chemotherapy. Cancer 33:384-393, 1974 CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. 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ANTHONY GRECO, M.D., HARMAR D. BRERETON, M.D., HARRY KENT, M.D., HARVEY ZIMBLER, M.D., JOHN MERRILL, M.D., RALPH E. JOHNSON, M.D.Cardiotoxicity of adriamycin and related anthracyclinesQuantification of combined radiation therapy and chemotherapy effects on critical normal tissuesUnusual cardiac reaction to chemotherapy following mediastinal irradiation in a patient with Hodgkin's diseaseCardiovascular Effects of Cancer TherapyScreening for Cardiovascular Disease in Survivors of Thoracic Radiation 1 January 1975Volume 82, Issue 1Page: 122-123KeywordsBody surface areaCardiomyopathiesHeart failureLungsRadiation therapySarcomaSkullSpine Issue Published: 1 January 1975 PDF DownloadLoading ...
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