title: Decline in pulmonary function in patients with breast cancer receiving dose-dense chemotherapy: a prospective study.
abstract: BACKGROUND
  Prompted by complaints of dyspnea in breast cancer patients receiving adjuvant dose-dense chemotherapy (DDC), we sought to evaluate the possible association of DDC with pulmonary dysfunction.
  
  
  METHODS
  A total of 34 consecutive patients receiving adjuvant DDC were enrolled. The chemotherapy regimen consisted of i.v. doxorubicin 60 mg/m(2) and cyclophosphamide 600 mg/m(2) (AC) every 14 days x4 with growth factor support followed by weekly i.v. paclitaxel 80 mg/m(2) x12. The following parameters were prospectively measured before and after the AC protocol (P1, P2) and at completion of paclitaxel treatment (P3): presence of dyspnea, blood pressure, pulse rate, hemoglobin, erythrocyte sedimentation rate, C-reactive protein level, cardiac ejection fraction, and pulmonary function. Repeated measures analysis was used to evaluate differences among the time points, and paired t-test was used to evaluate differences between consecutive time points.
  
  
  RESULTS
  Although only five patients (15%) complained of dyspnea, there was a significant decrease in mean carbon monoxide diffusing capacity (DLCO), in all patients from P1 (22.09 ml/min/mmHg) to P3 (15 ml/min/mmHg) and in 29 of 32 patients (90.6%) from P1 to P2 (15.96 ml/min/mmHg) (P<0.001).
  
  
  CONCLUSIONS
  DDC is associated with a statistical significant reduction in DLCO. Awareness of this potential toxicity may be important in women with preexisting lung disease.
authors.affiliation: Institute of Oncology, Davidoff Center, Beilinson Campus, Petah Tiqva and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. ryerushalmi@bccancer.bc.ca
authors.forename: R
authors.initials: R
authors.lastname: Yerushalmi
authors.forename: M R
authors.initials: MR
authors.lastname: Kramer
authors.forename: S
authors.initials: S
authors.lastname: Rizel
authors.forename: A
authors.initials: A
authors.lastname: Sulkes
authors.forename: K
authors.initials: K
authors.lastname: Gelmon
authors.forename: T
authors.initials: T
authors.lastname: Granot
authors.forename: V
authors.initials: V
authors.lastname: Neiman
authors.forename: S M
authors.initials: SM
authors.lastname: Stemmer
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000503:physiopathology*; D004305:Dose-Response Relationship, Drug; D006801:Humans; D011446:Prospective Studies; D012129:Respiratory Function Tests