Special focus on cardiac toxicity of different sequences of adjuvant doxorubicin/docetaxel/CMF regimens combined with radiotherapy in breast cancer patients.
OBJECTIVE
Cardiac toxicity associated with anthracyclines and taxanes and/or radiotherapy (RT) can be life-threatening and can adversely affect quality of life. The aim was to evaluate treatment-related cardiac toxicity in breast cancer patients treated with doxorubicin/docetaxel/CMF sequential or combined regimens and RT.


METHODS
From 1996 to 1998, 64 patients with stages II-III breast cancer were included in a pilot study that investigated the efficacy/feasibility of sequential and combined doxorubicin/docetaxel/CMF regimens. No patients had any cardiovascular history or ECG abnormalities. The same RT technique was performed in all patients. LVEF measurements were obtained at baseline, during, at the end of chemotherapy, at the end of radiotherapy and subsequently during the follow-up. A cardiac event was defined as a myocardial infraction or clinical evidence of congestive heart failure.


RESULTS
Median age was 48 years (range 29-65 years). The median follow-up was 6 years. Significant drop in the post-treatment LVEF occurred in 21 patients (median decrease of 10%). Notwithstanding, all patients have preserved normal cardiac function and regained their initial LVEF value during follow-up. No cardiac events were reported.


CONCLUSIONS
Sequential and combined doxorubicin/docetaxel/CMF regimens plus conventional RT in selected non high-risk cardiac patients are relatively safe without cardiac toxicity at mid-term follow-up.
Magné
Nicolas
N
Radiotherapy Department, Institut Jules Bordet, Bruxelles, Belgium. nicolas.magne@igr.fr
Castadot
Pierre
P
Chargari
Cyrus
C
Di Leo
Angelo
A
Philippson
Catherine
C
Van Houtte
Paul
P
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D016009:Chi-Square Distribution; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D000077143:Docetaxel; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D006331:Heart Diseases / Q000139:chemically induced* / Q000175:diagnosis; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects; D008875:Middle Aged; D009367:Neoplasm Staging; D010865:Pilot Projects; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D043823:Taxoids / Q000008:administration & dosage / Q000009:adverse effects*; D016896:Treatment Outcome
D043823:Taxoids; D000077143:Docetaxel; D004317:Doxorubicin; D003520:Cyclophosphamide; D005472:Fluorouracil; D008727:Methotrexate