Cardioprotection in patients undergoing chemo- and/or radiotherapy for neoplastic disease. A pilot study.
OBJECTIVE
To assess the cardioprotective efficiency of an antioxidant regimen (vitamins E, C and N-acetylcysteine) in patients receiving high dose chemo- and/or radiotherapy for malignant disease.


METHODS
Prospective, placebo controlled, randomized and double blinded pilot study involving 13 patients receiving chemotherapy and 12 patients receiving radiotherapy.


RESULTS
In patients receiving antioxidants, left ventricular ejection fraction did not change (63 +/- 4% to 63 +/- 4%). In the placebo group, ejection fraction changed from 67 +/- 6% to 61 +/- 4% (p = 0.03). No patient in the antioxidant group and 6/13 (46%) patients in the placebo group showed a fall of > 10% in the left ventricular ejection fraction. In the chemotherapy group, the left ventricular ejection fraction changed from 62% (+/- 2) to 63% (+/- 2) in the patients treated with antioxidants (ns) and from 63% (+/- 5) to 61% (+/- 5) in patients treated with placebo (ns). No patient showed a significant fall in ejection fraction in the antioxidant group, whereas 2/7 (29%) in the placebo group showed a reduction > or = 10%. In the radiotherapy group, left ventricular ejection fraction did not change ¿64% (+/- 6) to 64% (+/- 5)¿ in patients treated with antioxidants (ns) and changed from 70% (+/- 8) to 60% (+/- 4) in patients treated with placebo (p = 0.008). No patient in the antioxidant group, but 4/6 (66%) patients in the placebo group showed a fall of > or = 10% in ejection fraction.


CONCLUSIONS
The small number of patients in the study precludes a definitive statement. The preliminary results however suggest efficient cardioprotection by this nontoxic and inexpensive antioxidant combination, so larger studies are warranted for confirmation.
Wagdi
P
P
Department of Cardiology, University Hospital, Bern, Switzerland.
Fluri
M
M
Aeschbacher
B
B
Fikrle
A
A
Meier
B
B
D000111:Acetylcysteine / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000009:adverse effects; D000975:Antioxidants / Q000008:administration & dosage*; D001205:Ascorbic Acid / Q000008:administration & dosage; D004311:Double-Blind Method; D006321:Heart / Q000187:drug effects* / Q000528:radiation effects; D006801:Humans; D009369:Neoplasms / Q000628:therapy*; D010865:Pilot Projects; D011446:Prospective Studies; D015635:Radionuclide Ventriculography; D011878:Radiotherapy / Q000009:adverse effects; D011879:Radiotherapy Dosage; D013318:Stroke Volume / Q000187:drug effects; D014810:Vitamin E / Q000008:administration & dosage
D000970:Antineoplastic Agents; D000975:Antioxidants; D014810:Vitamin E; D001205:Ascorbic Acid; D000111:Acetylcysteine