含蒽环类化疗方案治疗乳腺癌的心脏毒副作用及右丙亚胺保护效果分析

Analysis of the cardiac side effects of anthracycline-based chemotherapy in the treatment of breast cancer and the protective effect of dexrazoxane

目的探讨含蒽环类化疗方案治疗乳腺癌的心脏毒副作用及右丙亚胺的保护效果。方法将110例乳腺癌患者随机分为两组,各55例。对照组给予含蒽环类药物化疗方案治疗,观察组在此治疗基础上加用右丙亚胺。两组均治疗4个周期,比较治疗前后血清脑利钠肽(BNP)、血清心肌肌钙蛋白T(cTnT)及心率(HR)、左室射血分数(LVEF),并记录其不良反应及1年内肿瘤复发率。结果治疗后,观察组BNP、cTnT、HR、LVEF较治疗前无明显变化(P>0.05),而对照组BNP、cTnT、HR较治疗前升高,LVEF则降低,差异有统计学意义(P<0.05);观察组不良反应发生率9.09%,低于对照组的25.45%(P<0.05);两组患者1年内肿瘤复发率比较,差异无统计学意义(P>0.05)。结论含蒽环类化疗方案治疗乳腺癌存在一定心脏毒副作用,右丙亚胺可在不影响抗肿瘤效果下降低心脏损伤,值得临床推广应用。

Objective To analyze the the cardiac side effects of anthracycline-based chemotherapy in the treatment of breast cancer and the protective effect of dexrazoxane. Methods One hundred and ten patients with breast cancer were divided into the observation group and the control group with the random number table method, with 55 cases in each group. The control group was only treated with anthracycline-based chemotherapy. On this basis, the observation group was treated with dexrazoxane. All the patients were treated for 4 courses. The serum brain natriuretic peptide（ BNP）, cardiac troponin （cTnT）, heart rate （HR） and left ventricular ejection fraction （LVEF） before and after treatment were compared between the two groups. The adverse reactions and 1-year recurrence rate of tumor were recorded. Results After treatment, there were no significant changes of BNP, cTnT, HR and LVEF in the observation group （P 〉 0. 05 ） , but BNP, cTnT and HR in control group were significantly increased while LVEF was decreased （P 〈 0. 05 ） ;The incidence rate of adverse reactions in the observation group （9. 09% ） was lower than that （25.45 % ） in the control group （P 〈 0. 05 ）, and there was no significant difference in 1 -year recurrence rate between the two groups （ P 〉 0. 05 ）. Conclusion There may be some cardiac side effects of anthracycline-based chemotherapy in the treatment of breast cancer. Dexrazoxane may reduce cardiac injury without affecting the anti-tumor effect.