| Objection:Cancer and cardiovascular disease are the leading global health burdens worldwide.Cancer can invade heart,adjacent vessels and tissues.Furthermore,many chemotherapy agents are associated with cancer treatment-related cardiac dysfunction(CTRCD).Radiation exposure of the heart during radiotherapy of cancer has shown to increase the risk of heart disease.Based on the caner survey of China in 2015,breast cancer is the most common cancer in women with incidence rate and mortality rate as17.01%and 2.51%respectively.The success of breast cancer treatment including chemotherapy,radiotherapy and adjuvant cancer therapy,has dramatically increased the survival rate of patients over the past three decades.However,all these cancer therapies have the side effect of cardiotoxicity.With the prolonged life-span of the patients,the CTRCD has become more and more important.As for the risk factors for cadiotoxicity of breast cancer therapy,most studies are about monotherapy.The studies about the risk factors of combined therapies are rare.This retrospective study was aimed to explore the correlation between different types of combined therapies and the incidence of CTRCD in women with breast cancer receiving adjuvant therapy which might provide the basis for evaluating the risk factors for breast cancer therapy and monitoring and preventing of CTRCDMethods:1.This study comprised of 327 patients who received adjuvant therapy in Liaoning Tumor Hospital from January 2016 to June 2017.2.All subjects were investigated by a unified survey form.The clinical data were extracted form electronic medical records.The contents included name,age,average heart rate,systolic and diastolic blood pressure,behaviors as smoking or alcohol intake,brain natriuretic peptide(BNP),fasting blood glucose and echocardiography before and 6 months after cancer therapy.Enumeration data were presented as frequency.Data were analyzed by t test,Rank-Sum test,and?~2 test.CTRCD group and non-CTRCD group were matched with age(?2 years old)at the ratio of 1:2.Correlation between different therapies and CTRCD were analyzed by conditional logistic regression.Results:Of 327 subjects,38 were diagnosed as CTRCD and 289 were diagnosed as non-CTRCD.1.As for radiotherapy,the incidence rates of CTRCD were not significantly different among patients receiving non-radiotherapy,right side radiotherapy and left side radiotherapy(χ2=0.301,P=0.860;10.9%vs.11.4%vs.13.3).2.As for different types of combined therapies(Anthracyclines monotherapy,Anthracyclines plus radiotherapy,Anthracyclines plus Trastuzumab therapy,Anthracyclines plus Trastuzumab and radiotherapy),the incidence rate of CTRCD was significantly higher in patients receiving Anthracyclines plus Trastuzumab therapy than those receiving Anthracyclines monotherapy or Anthracyclines plus radiotherapy(Bonferroni correction,P<0.008,8.2%vs.40.0%;Bonferroni correction,P<0.008,9.9%vs.40.0%).3.In age≥50 group,the incidence rate of CTRCD was not significantly different among different therapy groups.In age<50 group,the rate of CTRCD in patients receiving Anthracyclines plus Trastuzumab therapy was significantly higher than Anthracyclines monotherapy Bonferroni correction,P<0.008;57.1%vs.5.7%).4.In patients with right breast cancer,the incidence rates were not significantly different among 4 types of therapies.In patients with left breast cancer,the incidence rate of CTRCD was significantly higher in those patients who received Anthracyclines plus Trastuzumab therapy than Anthracyclines monotherapy(Bonferroni correction,P<0.008;44.4%vs.6.1%).5.Analyzed by conditional logistic regression,Anthracyclines plus Trastuzumab therapy increased the risk of CTRCD by 24.244(OR=24.244,95%CI:2.202-266.973).Conclusion:1.The Trastuzumab combined therapy increased the incidence risk of CTRCD in patients receiving Anthracyclines therapy.2.In short term(6 months),radiotherapy didn’t increase the incidence risk of CTRCD... |
PDF Full Text Request