右丙亚胺对表阿霉素化疗的老年乳腺癌患者心脏保护作用的研究

Protective effect of Dexrazoxane on Epirubicin cardiotoxicity in the elderly patients with breast cancer

目的 观察右丙亚胺对老年女性乳腺癌患者接受表阿霉素化疗时的心脏保护作用.万法 选取2008年5月至2011年11月84例年龄＞65岁乳腺癌术后接受CEF方案及TE方案化疗的患者,随机分为两组：试验组42例,接受含表阿霉素方案化疗加右丙亚胺;对照组42例,接受含表阿霉素方案化疗不加右丙亚胺.所有患者连续随访2年,监测患者心肌钙蛋白T（cTnT）、左心室射血分数（LVEF）的变化情况,以及化疗毒性反应情况.结果 试验组患者心肌钙蛋白T（cTnT）的升高、左心室射血分数（LVEF）的下降均低于对照组,两组患者化疗毒性反应无差别,心脏毒性事件发生率差异无统计学意义.结论 对于老年乳腺癌患者,应用表阿霉素化疗从第一周期开始就已产生了心脏毒性.联合应用右丙亚胺能降低表阿霉素对老年乳腺癌患者引起的心脏毒性,而并不加重患者非心脏毒性反应,可增加老年乳腺j癌患者的治疗机会.

Objective To observe the preventive and therapeutic effects of dexrazoxane （Dexrazoxane,DEX） against the cardiac toxicity induced by epirubicin（Epirubicin,EPI） in the elderly patients with breast cancer.Methods The elderly patients with breast cancer from 2008.5-2011.11 were enrolled,all the patients were receipted the chemotherapy regimen of TE （Epirubicin＋Docetaxel） or CEF （Epirubicin＋Cyclophosphamide＋Fluorouracil）,and whose age were equal or greater than 65 years old.All the patients were randomly assigned to be treated with（42 patients） or without（42 patients） Dexrazoxane.All of the patients were continuous follow-up in 2 years,and the cardiac troponin T （TNT） and left ventricular ejection fraction （LVEF） were measured.Results The increase of the TNT and the decrease of the LVEF in the treatment group were lower than those of the control group（P＜0.05）.The toxic reaction and the cardiac events in two groups were no difference（P＞0.05）.Conclusion The cardiac toxicity had been production from the first cycle in the elder breast cancer patients which receipted Epirubicin can be reduced when combined with dexrazoxane,and there were no non-cardiac toxicity increased,and then increase the therapeutic opportunities for the elder breast cancer patients.