A Study Of TE Chemotherapy Protocol(Paclitaxel + Epirubicin) Caused Cardiac Toxicity In Patients With Breast Cancer

Objective:To observe the cardiaovascular toxicity induced by TE chemotherapy protocol in patients with breast cancer and explore a simple and effective method to monitor the toxicity.Methods:Forty consecutive female patients with breast cancer who underwent chemotherapy from Jan.2016 to Dec.2017 were including in this study,the median age was 47 years old(aged from 33 to 63).All patients were diagnosed breast cancer by Histopathology,37 cases of them were invasive ductal carcinomas,2 cases of them were invasive lobular cancer,1 case of them was rare clinically glycogen rich clear cell carcinoma.All patients had no history of cardiovascular disease,systemic metastasis,radiation therapy or any other drugs with cardiaovascular toxicity at baseline.The electrocardiogram,echocardiography,and serum troponin I were normal before therapy.TE(epirubicin+paclitaxel)chemotherapy protocol was used for 6 cycles of therapy.The echocardiography,electrocardiogram and serum troponin I(CTnI)and other related data were detected 1 days before chemotherapy and first months,second months and third months after the first chemotherapy.Using SPSS19.0 and Graphpad Prism 5.1 statistical analysis software for data analysis.The measurement data are described by mean±standard deviation(x±s).T test and variance analysis were used for the comparison of CTnI level data.The comparison of counting data was tested by chi square test,and the difference of P<0.05 was statistically significant.Results:Before chemotherapy,the serum CTn I concentration was(0.013±0.008)ng/L,and no abnormalities were observed in the ECG and echocardiography.1 month,2months and 3 months after the first time chemotherapy,the serum CTn I concentration increased to 0.037±0.012ng/L,0.162±0.035 ng/L and 0.275±0.086 ng/L respectively.Compared with pre chemotherapy,the T values of CTnI were 10.52,26.25,19.19,and P<0.01 respectively,and the difference was statistically significant,Four groups of data were analyzed for variance,F=266.5,P<0.0001,and the difference was also statistically significant;The left ventricular ejection fraction fell more than 10%in 10,14 and 21 patients respectively.Compared with pre chemotherapy,the?~2 values of the decrease by more than 10%were 11.43,16.97 and28.47 respectively,and P<0.01.The difference was statistically significant.Four groups of data were analyzed together with significant differences(?~2=22.79,P<0.0001),and the difference was statistically significant;.The occurrence rate of abnormal ECG was 25%,37.5%and 52.5%respectively at the same time,The difference between each group was statistically significant(?~2=22.79,P<0.0001).Conclusion:TE chemotherapy protocol can cause significant cardiac toxicity.The serum CTn I concentration combined electrocardiogram(ECG)and echocardiography can be used as a predictor of cardiac toxicity in TE(epirubicin+paclitaxel)chemotherapy protocol.