Comparison of epirubicin and doxorubicin cardiotoxicity in children and adolescents treated within the German Cooperative Soft Tissue Sarcoma Study (CWS).
OBJECTIVE
Up to now, cardiotoxicity of epirubicin has been studied almost exclusively in adult cancer patients. The aim of this study was to investigate epirubicin in children and adolescents, in comparison with doxorubicin.


METHODS
About 172 soft tissue sarcoma patients (mean age at diagnosis: 8.3 years), treated with epirubicin (median cumulative dose: 450 mg/m2) or doxorubicin (median cumulative dose: 240 mg/m2) within the high-risk group of the CWS-96 study, were examined in a prospective multicentre study. Heart function was analysed by echocardiography, measuring left-ventricular fractional shortening (FS). The median follow up was 27.7 months.


RESULTS
Incidence of clinically manifest cardiomyopathy was 0% (0/60; 95% CI: 0-6.0%) in patients treated with epirubicin, and 0.9% (1/108; 95% CI: 0-5.1%) in patients treated with doxorubicin. A further three patients showed subclinical cardiomyopathy. There was no difference in FS between the two treatment arms.


CONCLUSIONS
Cardiotoxicity was low in our study. For the short term, cardiotoxicity seems to be only a minor problem in patients treated with epirubicin as applied in this cohort.
Stöhr
W
W
Department of Pediatric Oncology, LESS Center, University Hospital for Children and Adolescents, Loschgestrasse 15, 91054, Erlangen, Germany.
Paulides
M
M
Brecht
I
I
Kremers
A
A
Treuner
J
J
Langer
T
T
Beck
J D
JD
D000293:Adolescent; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D002313:Cardiomyopathy, Restrictive / Q000139:chemically induced* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects*; D004452:Echocardiography; D015251:Epirubicin / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006321:Heart / Q000187:drug effects* / Q000503:physiopathology*; D006334:Heart Function Tests; D006801:Humans; D015994:Incidence; D008297:Male; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D012509:Sarcoma / Q000188:drug therapy* / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000187:drug effects
D000903:Antibiotics, Antineoplastic; D015251:Epirubicin; D004317:Doxorubicin