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(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 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.