title: Cardiotoxicity from intensive chemotherapy combined with radiotherapy in breast cancer.
abstract: Cardiac function was evaluated in 86 breast cancer patients after standard chemotherapy, followed by ablative chemotherapy and chest irradiation. One patient died of subacute heart failure 3 months after ablative chemotherapy. At a minimum of 1 year's follow-up (range 1-11 years) left vertricular ejection fraction (LVEF) was marginally abnormal in 4 of 27 disease-free survivors. One exceptional patient who received two transplantations is alive, with serious heart failure occurring after the second ablative chemotherapy. Including this patient, the percentage of patients free of clinical and subclinical cardiac dysfunction at 7 years is 78% (95% CI 61-95%). After ablative chemotherapy, cardiotoxicity was rarely life-threatening. The impact of subclinical cardiotoxicity in the long term is not clear and needs continued evaluation.
authors.affiliation: Department of Internal Medicine, University Hospital Groningen, The Netherlands.
authors.forename: H
authors.initials: H
authors.lastname: de Graaf
authors.forename: W V
authors.initials: WV
authors.lastname: Dolsma
authors.forename: P H
authors.initials: PH
authors.lastname: Willemse
authors.forename: W T
authors.initials: WT
authors.lastname: van der Graaf
authors.forename: D T
authors.initials: DT
authors.lastname: Sleijfer
authors.forename: E G
authors.initials: EG
authors.lastname: de Vries
authors.forename: N H
authors.initials: NH
authors.lastname: Mulder
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D003131:Combined Modality Therapy / Q000009:adverse effects; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D015251:Epirubicin / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006321:Heart / Q000187:drug effects*; D006801:Humans; D008875:Middle Aged; D017697:Premenopause; D016019:Survival Analysis; D016277:Ventricular Function, Left / Q000187:drug effects*
chemical_list: D015251:Epirubicin; D004317:Doxorubicin; D003520:Cyclophosphamide