Evaluation of Demographic Parameters, Disease Burden, and Cardiovascular Risk Factors in Patients Who Received Primary Prophylaxis with Dexrazoxane for Prevention of Anthracycline-Induced Cardiotoxicity

摘要

Objective: This retrospective study aimed to reveal the demographic parameters, disease burden, and cardiovascular risk factors in patients who received primary prophylaxis with dexrazoxane for the prevention of anthracycline-induced cardiotoxicity. We also evaluated the compliance of dexrazoxane use as per the American Society of Clinical Oncology (ASCO) Clinical Practice Guideline (CPG) criteria in these patients. Material and Methods: Data of 44 patients were retrospectively analyzed. A data registration form comprising 31 questions, including demographic characteristics, anthracycline treatment and dosage, chemotherapeutic agents, radiotherapy, surgical procedures, and data on cardiac functions and cardiovascular risk parameters, were retrospectively analyzed for each patient included in the study. Results: The average age of patients was 53 years, and the percentage of female patients was 88.6%, among which, the primary diagnosis was breast cancer. In 32 of 44 patients, no oncological treatment was administered before the anthracycline treatment. In all 44 patients, the ejection fraction value before anthracycline treatment was 60% or higher. Eleven patients received cumulative high-dose anthracycline treatment (doxorubicin ≥250 mg/m2, epirubicin ≥600 mg/m2). As per the recommendations of the ASCO CPG, 77.2% of patients in the study population were at high risk for the development of cardiac dysfunction. For 22.8% of the patients, the guideline recommendation for the development of cardiac dysfunction did not exist. Six of these ten patients, which are not considered to be at high risk for developing cardiac dysfunction, had at least one of the cardiovascular risk factors: smoking, hypertension, diabetes, dyslipidemia, or obesity. Conclusion: Cardiotoxicity of anthracyclines is dose-dependent and can occur at any time in the treatment course with acute, subacute, and late-onset presentations. Cardiotoxicity of anthracyclines is one of its most serious adverse effects though occasionally, precluding its usage even in potentially curative cases. Co-administration of dexrazoxane has been shown to reduce cardiotoxicity effectively. Further studies on the use of dexrazoxane in patients who are not in the high-risk group for anthracycline-induced cardiotoxicity are warranted.