Late cardiac effects of adjuvant chemotherapy in breast cancer survivors treated on southwest oncology group protocol s8897

被引:72
作者
Ganz, Patricia A.
Hussey, Michael A.
Moinpour, Carol M.
Unger, Joseph M.
Hutchins, Laura F.
Dakhil, Shaker R.
Giguere, Jeffrey K.
Goodwin, J. Wendall
Martino, Silvana
Albain, Kathy S.
机构
[1] Univ Calif Los Angeles, Sch Med & Publ Hlth, Div Canc Prevent & Control Res, Jonsson Comprehens Canc Ctr, Los Angeles, CA 90095 USA
[2] Angeles Clin & Res Inst, Santa Monica, CA USA
[3] SW Oncol Grp, Ctr Stat, Seattle, WA USA
[4] Univ Arkansas Med Sci, Little Rock, AR 72205 USA
[5] Wichita Community Clin Oncol Program, Wichita, KS USA
[6] Greenville Community Clin Oncol Program, Greenville, SC USA
[7] Ozarks Reg Community Clin Oncol Program, Springfield, MO USA
[8] Loyola Univ, Stritch Sch Med, Maywood, IL 60153 USA
关键词
D O I
10.1200/JCO.2007.11.8877
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose The late cardiac effects of adjuvant anthracycline therapy in survivors of early-stage breast cancer have had limited study. Subclinical and clinical cardiac late effects may contribute to added comorbidity over time. Patients and Methods We recruited patients treated on Southwest Oncology Group (SWOG) protocol S8897 who had been randomly assigned to adjuvant chemotherapy with or without doxorubicin. Left ventricular ejection fraction (LVEF) was evaluated at 5 to 8 years and 10 to 13 years after treatment randomization. Cardiac risk factors and events were reported by clinicians annually between the two assessments. Results A total of 180 breast cancer survivors from a potential sample of 1,176 patients were entered, 163 patients at 5 to 8 years and 17 additional patients at 10 to 13 years, with 93 longitudinal assessments of LVEF. There was no significant difference in the proportion of women with an LVEF less than 50% at 5 to 8 (cyclophosphamide, doxorubicin, and fluorouracil [CAF] v cyclophosphamide, methotrexate, and fluorouracil [CMF]: 5% v 7%; P = .68) or 10 to 13 years (CAF v CMF: 3% v 0%; P = .16); however, in an exploratory analysis, the mean LVEF in the doxorubicin group was statistically significantly lower in the 5- to 8-year sample (64.8% v 61.4%; P = .01) but not in the 10- to 13-year sample. In the longitudinal analysis, there was no significant deterioration in LVEF. Conclusion Women enrolled onto an adjuvant chemotherapy treatment clinical trial for breast cancer were successfully recruited to participate in a research study of the late effects of treatment, although many SWOG institutions and potentially eligible patients chose not to participate. In this selected sample, with up to 13 years of follow-up, exposure to doxorubicin did not increase the likelihood of adverse cardiac effects.
引用
收藏
页码:1223 / 1230
页数:8
相关论文
共 19 条
[1]  
[Anonymous], MMWR MORB MORTAL WKL
[2]   Effect of screening and adjuvant therapy on mortality from breast cancer [J].
Berry, DA ;
Cronin, KA ;
Plevritis, SK ;
Fryback, DG ;
Clarke, L ;
Zelen, M ;
Mandelblatt, JS ;
Yakovlev, AY ;
Habbema, JDF ;
Feuer, EJ .
NEW ENGLAND JOURNAL OF MEDICINE, 2005, 353 (17) :1784-1792
[3]   Long-term cardiac follow-up in relapse-free patients after six courses of fluorouracil, epirubicin, and cyclophosphamide, with either 50 or 100 mg of epirubicin, as adjuvant therapy for node-positive breast cancer:: French adjuvant study group [J].
Bonneterre, J ;
Roché, H ;
Kerbrat, P ;
Fumoleau, P ;
Goudier, MJ ;
Fargeot, P ;
Montcuquet, P ;
Clavère, P ;
Barats, JC ;
Monnier, A ;
Veyret, C ;
Datchary, J ;
Van Praagh, I ;
Chapelle-Marcillac, I .
JOURNAL OF CLINICAL ONCOLOGY, 2004, 22 (15) :3070-3079
[4]   Fatigue in long-term breast carcinoma survivors - A longitudinal investigation [J].
Bower, JE ;
Ganz, PA ;
Desmond, KA ;
Bernaards, C ;
Rowland, JH ;
Meyerowitz, BE ;
Belin, TR .
CANCER, 2006, 106 (04) :751-758
[5]   American Society of Clinical Oncology clinical evidence review on the ongoing care of adult cancer survivors: Cardiac and pulmonary late effects [J].
Carver, Joseph R. ;
Shapiro, Charles L. ;
Ng, Andrea ;
Jacobs, Linda ;
Schwartz, Cindy ;
Virgo, Katherine S. ;
Hagerty, Karen L. ;
Somerfield, Mark R. ;
Vaughn, David J. .
JOURNAL OF CLINICAL ONCOLOGY, 2007, 25 (25) :3991-4008
[6]   Coronary artery findings after left-sided compared with right-sided radiation treatment for early-stage breast cancer [J].
Correa, Candace R. ;
Litt, Harold I. ;
Hwang, Wei-Ting ;
Ferrari, Victor A. ;
Solin, Lawrence J. ;
Harris, Eleanor E. .
JOURNAL OF CLINICAL ONCOLOGY, 2007, 25 (21) :3031-3037
[7]   Chemotherapy and cardiotoxicity in older breast cancer patients: A population-based study [J].
Doyle, JJ ;
Neugut, AI ;
Jacobson, JS ;
Grann, VR ;
Hershman, DL .
JOURNAL OF CLINICAL ONCOLOGY, 2005, 23 (34) :8597-8605
[8]   Cardiotoxicity of cancer therapy [J].
Floyd, JD ;
Nguyen, DT ;
Lobins, RL ;
Bashir, Q ;
Doll, DC ;
Perry, MC .
JOURNAL OF CLINICAL ONCOLOGY, 2005, 23 (30) :7685-7696
[9]  
Ganz PA, 2002, JNCI-J NATL CANCER I, V94, P39
[10]   Breast cancer in younger women: Reproductive and late health effects of treatment [J].
Ganz, PA ;
Greendale, GA ;
Petersen, L ;
Kahn, B ;
Bower, JE .
JOURNAL OF CLINICAL ONCOLOGY, 2003, 21 (22) :4184-4193