Dynamic monitoring of cardio-specific markers and markers of thyroid gland function in cancer patients--a pilot study.
BACKGROUND
With the increased effectiveness of anticancer therapy, much more attention is being paid to the monitoring of the side-effects of chemotherapy, which often constitute a limiting factor in anticancer therapy. In this pilot study, the results of our monitoring of changes in cardio-specific markers and thyroid gland parameters in patients with colorectal carcinoma in the course of adjuvant and palliative chemotherapy are presented.


METHODS
A total of 42 patients with colorectal carcinoma were monitored (median age 52 years, range 34-82 years); in these patients a post-operative adjuvant or palliative chemotherapy was applied (de Gramont's or FOLFIRI regimen). In all of these patients, the cardio-specific markers brain natriuretic peptide (BNP) and troponin I were assessed, as well as markers of thyroid gland function, TSH and FT4.


RESULTS
In the course of chemotherapy, more than half of the patients showed laboratory signs of coronary ischemia; in 6 of these (14%) coronary ischemia was manifested with troponin I levels above 0.3 microg/L. Twenty patients (48%) had laboratory signs of heart failure in the course of adjuvant or palliative chemotherapy. A more frequent incidence of elevated cardio-specific enzymes was observed in continual regimens than in bolus application of fluorouracil. Reduced TSH values were observed in the course of chemotherapy in 9 patients (21%), without changes in FT4 values. An increase in TSH values was observed in 4 patients (10%), again without changes in FT4 values.


CONCLUSIONS
The pilot study demonstrated that in patients undergoing treatment for colorectal carcinoma by adjuvant or palliative chemotherapy on the basis of 5-fluorouracil, it is advisable to check for possible cardiotoxicity and simultaneously to monitor thyroid gland functions. This systematic monitoring may improve the quality of life in cancer patients.
Holubec
L
L
Departments of Oncology, University Hospital and Medical Faculty Pilsen, Charles University Prague, Czech Republic. holubec@fnplzen.cz
Topolcan
O
O
Finek
J
J
Salvet
J
J
Svoboda
T
T
Svobodova
S
S
Mrazkova
P
P
Ludvikova
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D015179:Colorectal Neoplasms / Q000188:drug therapy; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D006321:Heart / Q000187:drug effects*; D006333:Heart Failure / Q000139:chemically induced; D006801:Humans; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000139:chemically induced; D020097:Natriuretic Peptide, Brain / Q000187:drug effects; D010166:Palliative Care; D010865:Pilot Projects; D013961:Thyroid Gland / Q000187:drug effects*; D013972:Thyrotropin / Q000187:drug effects; D013974:Thyroxine / Q000187:drug effects; D019210:Troponin I / Q000187:drug effects
D019210:Troponin I; D020097:Natriuretic Peptide, Brain; D013972:Thyrotropin; D013974:Thyroxine; D005472:Fluorouracil