| 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. |
| 不同剂量表阿霉素在乳腺癌辅助治疗中心脏毒性和远期疗效的研究 |
| 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 |
| DOI：10.1007/s10330-014-0014-3 |
| 中文关键词: 表阿霉素；乳腺癌；辅助化疗；心脏毒性；远期疗效 |
| 英文关键词: epirubicin; breast cancer; adjuvant chemotherapy; cardiotoxicity; long-term efficacy |
| 基金项目: |
| Author Name | Affiliation | E-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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| 中文摘要: |
| 目的 观察不同剂量表阿霉素在乳腺癌辅助治疗中引起的心脏毒性，并评估远期疗效。方法 根据CEF辅助化疗方案中表阿霉素的用药剂量，将180例乳腺癌术后患者随机分为高剂量组（90mg/m2）、中剂量组（70mg/m2）和低剂量组（50mg/m2），主要观测指标为患者心脏毒性反应，次要观测指标为5年总生存率和5年无病生存率。结果 高、中、低剂量组化疗期间出现心悸、胸闷、夜间阵发性呼吸困难等不适分别为6例、4例、3例，发生心电图改变分别为7例、5例和4例，超声心动图LVEF<50％各有1例，三组比较差异无统计学意义(P>0.05)。5年无病生存率统计高剂量组73.3% (44/60)，中剂量组为53.3% (32/60)，低剂量组为41.6% (25/60)。5年总生存率统计高剂量组为85% (51/60)，中剂量组为68.3% (41/60)，低剂量组为58.3% (35/60)。三组间5年无病生存率和5年总生存率差异均具统计学意义（P<0.05）。结论 大剂量表阿霉素辅助化疗能够提高乳腺癌术后患者的5年OS和5年DFS，且心脏毒性反应为轻中度，患者耐受性较好。 |
| 英文摘要: |
| 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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