Yang Liu,Zhenyu You,Xiaohui Su,Bona Liu,Xuefei Liu. The cardiotoxicity and long-term efficacy of different doses of epirubicin in the adjuvant treatment of breast cancer patients: A case control study. Oncol Transl Med, 2014, 13: 410-412.
The cardiotoxicity and long-term efficacy of different doses of epirubicin in the adjuvant treatment of breast cancer patients: A case control study
Received:June 30, 2014  Revised:August 26, 2014
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KeyWord:epirubicin; breast cancer; adjuvant chemotherapy; cardiotoxicity; long-term efficacy
Author NameAffiliationE-mail
Yang Liu Department of Oncology, 202 Hospital of the PLA, Shenyang 110003, China doctor_yangliu@163.com 
Zhenyu You Department of Oncology, 202 Hospital of the PLA, Shenyang 110003, China  
Xiaohui Su Department of Gastric Surgery, Cancer Hospital of Liaoning Province, Shenyang 110042, China  
Bona Liu Department of Oncology, 202 Hospital of the PLA, Shenyang 110003, China  
Xuefei Liu Department of Oncology, 202 Hospital of the PLA, Shenyang 110003, China  
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Abstract:
      Objective: The aim of the study was to observe the cardiac toxicity caused by different doses of epirubicin in the adjuvant treatment of breast cancer and to evaluate the long-term efficacy. Methods: The 180 cases of breast cancer patients received epirubicin based adjuvant chemotherapy. The patients were randomly assigned to high-dosage group (90 mg/m2), medium-dosage group (70 mg/m2) and low-dosage group (50 mg/m2), the primary endpoint was cardiac toxicity. The secondary outcomes were the 5-year overall survival (OS) and 5-year disease-free survival (DFS). Results: During chemotherapy, the clinical symptoms such as palpitation, dyspnea and paroxysmal nocturnal dyspnea occurred in 6 patients with the high-dosage group, 4 patients with the medium-dosage group and 3 patients with the low-dosage group. The number of patients who had changed in electrocardiogram (ECG) was 7, 5 and 4 in three groups, respectively. The echocardiographic showed each group had only one case with LVEF < 50%, there was no significantly difference (P > 0.05). In the three groups, the 5-year DFS rates were 73.3% (44/60) in high-dose group, 53.3% (32/60) in medium-dose group and 41.6% (25/60) in low dose group. The 5-year OS rates were 85.0% (51/60), 68.3% (41/60) and 58.3% (35/60) in three groups, respectively. The differences were statistically significant (P < 0.05). Conclusion: The high-dose epirubicin in adjuvant chemotherapy with CEF (cyclophosphamide, epirubicin and fluorouracil) regimen could improve the 5-year OS rate and 5-year DFS rate on patients of breast cancer. The cardiotoxicity was mild-moderate and well tolerated.
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