Key result
C-ESWT prevented the decline in left ventricular global longitudinal strain by a mean difference of 10.4% (p<0.001) compared to control in breast cancer patients receiving doxorubicin.
Why the study?
Doxorubicin causes LV dysfunction and late-onset cardiomyopathy, but an effective and clinically applicable preventive treatment is yet to be discovered.
Does Cardiac-Extracorporeal shockwave therapy (C-ESWT) prevent subclinical cardiotoxicity in breast cancer patients receiving doxorubicin?
RCT (n=64)
Open-label with blinded outcome assessment
Randomly assigned
No
Does Cardiac-Extracorporeal shockwave therapy (C-ESWT) prevent subclinical cardiotoxicity in breast cancer patients receiving doxorubicin?
Prophylactic cardiac extracorporeal shock wave therapy significantly attenuated the decline in left ventricular global longitudinal strain in breast cancer patients receiving doxorubicin.
C-ESWT may attenuate doxorubicin-related LVGLS decline and CTRCD; leaves open whether findings warrant prospective confirmation before clinical use.
Background Doxorubicin is a highly effective anti-cancer drug that causes left ventricular (LV) dysfunction and induces late-onset cardiomyopathy. However, an effective and clinically applicable preventive treatment is yet to be discovered. Objective Cardiac-Extracorporeal shockwave therapy (C-ESWT) has been suggested to treat inflammatory and ischemic diseases and protect cardiomyocytes from doxorubicin-induced cardiomyopathy. This study aims to assess the safety and efficacy of C-ESWT in the prevention of subclinical cardiotoxicity. Methods We enrolled 64 breast cancer patients. C-ESWT group 33 patients were treated with our C-ESWT (200 shots/spot at 0.09 mJ/mm2 for 20 spots, 3 times every six weeks). The efficacy endpoints were the difference in left ventricular global longitudinal strain (LVGLS) change by 2D speckle tracking echocardiography and chemotherapy-related cardiac dysfunction (CTRCD). Echocardiography was performed on the baseline line and every 4 cycles of chemotherapy, followed by a follow-up 3,6 months after chemotherapy to compare the incidence of cardiomyopathy of subclinical LV dysfunction due to chemotherapy between the two groups. Results Participants averaged 50 ± 9 years in age, 100% female. In the results of follow-up 6 months after the end of chemotherapy, there was a significant difference in delta LVGLS between the C-ESWT group and the control group (LVGLS; −1.1 ± 10.9% vs. −11.5 ± 11.6% p-value; <0.001). A total of 23% (15 patients) of patients developed CTRCD (Control group; 13 vs. C-ESWT group; (2). C-ESWT was performed safely without any serious adverse events. Conclusion In this prospective study, C-ESWT established efficacy in preventing subclinical cardiotoxicity, especially in breast cancer patients using doxorubicin chemotherapy, and the safety of C-ESWT. Clinical Trial Registration ClinicalTrials.gov , identifier (NCT05584163).
No takes yet. Share an insight, caveat, or question.
Song et al. (2024) conducted an RCT in Breast cancer receiving doxorubicin (n=64). Cardiac Extracorporeal Shock Wave Therapy (C-ESWT) vs. Standard chemotherapy containing doxorubicin (Control) was evaluated on Change in left ventricular global longitudinal strain (LVGLS) from baseline to 6 months (MD 10.4, 95% CI 4.50-16.36, p=<0.001). C-ESWT prevented the decline in left ventricular global longitudinal strain by a mean difference of 10.4% (p<0.001) compared to control in breast cancer patients receiving doxorubicin.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: