不同剂量表阿霉素治疗乳腺癌心脏毒性观察

Cardiac Toxicity of Epirubicin in Treating Breast Cancer

目的探讨表阿霉素剂量强度与心脏毒性的关系。方法对107例局部晚期乳腺癌患者应用不同剂量强度的CAF方案化疗,所有患者连续随访1年,通过监测患者化疗第2周期末、第4周期末、第6周期末及化疗后第3月末、第6月末心电图、心功能评价、心脏超声检查心脏射血分数,临床对照观察化疗后患者的心脏毒性反应。结果表阿霉素低剂量(50 mg/m2)组较少出现心电图异常,3例有心电图一过性改变者,较快的在2周内恢复正常。高剂量组(75mg/m2)5例有心电图改变,有3例在2周内恢复正常,1例有所减轻,但1例在2周后仍无改善,之后经超声心动图检查诊断为充血性心力衰竭。结论大多数患者能够较好的耐受高剂量的CAF化疗方案。

Objective To investigate the relationship between the dose of epirubicin and its heart toxicity. Methods All 107 patients with locally advanced breast cancer received varietal dose of CAF combination chemotherapy regimens, and all patients were followed up continuously for one year. Then by means of electrocardiogram ,evaluation of cardiac function and heart ejection fraction at end of the 2nd week,the 4th week,the 6th week and the 3rd month,the 6th month,the heart toxicity after chemothera- py in patients were observed and compared. Results Low doses of epriubicin （50 mg,/m2 ） group appeared less abnormal, the e- lectrocardiogram changed in 3 cases, but all recovered within 2 weeks. In the high dose group, the electrocardiogram changed in 5 cases（75 mg/m2） , after the treatment,3 cases recovered normally in two weeks, 1 case alleviated, but 1 case had not been im- proved in 2 weeks,which was confirmed the congestive heart failure by echocardiography detection. Conclusion Most of the pa- tients with locally advanced breast cancer can well tolerate the high doses of CAF chemotherapy regimens.