title: Dexrazoxane for preventing anthracycline cardiotoxicity in children with solid tumors.
abstract: This study attempted to assess the incidence and outcome of anthracycline cardiotoxicity and the role of dexrazoxane as a cardioprotectant in childhood solid tumors. The dexrazoxane group included 47 patients and the control group of historical cohort included 42. Dexrazoxane was given in the 10:1 ratio to doxorubicin. Fractional shortening and systolic and diastolic left ventricular diameters were used to assess the cardiac function. The median follow-ups were 54 months in the dexrazoxane group and 86 months in the control group. The mean cumulative doses of doxorubicin were 280.8+/-83.4 mg/m(2) in the dexrazoxane group and 266.1+/-75.0 mg/m(2) in the control group. The dexrazoxane group experienced significantly fewer cardiac events (27.7% vs. 52.4%) and less severe congestive heart failure (6.4% vs. 14.3%) than the control group. Thirteen cardiotoxicities including one cardiac death and 2 congestive heart failures occurred in the dexrazoxane group, and 22 cardiotoxicities including 2 cardiac deaths and 4 congestive heart failures, in the control group. Five year cardiac event free survival rates were 69.2% in the dexrazoxane group and 45.8% in the control group (P=0.04). Dexrazoxane reduces the incidence and severity of early and late anthracycline cardiotoxicity in childhood solid tumors.
authors.affiliation: Department of Pediatrics, Seoul National University Bundang Hospital, Sungnam, Korea.
authors.forename: Hyoung Soo
authors.initials: HS
authors.lastname: Choi
authors.forename: Eun Sil
authors.initials: ES
authors.lastname: Park
authors.forename: Hyoung Jin
authors.initials: HJ
authors.lastname: Kang
authors.forename: Hee Young
authors.initials: HY
authors.lastname: Shin
authors.forename: Chung Il
authors.initials: CI
authors.lastname: Noh
authors.forename: Yong Soo
authors.initials: YS
authors.lastname: Yun
authors.forename: Hyo Seop
authors.initials: HS
authors.lastname: Ahn
authors.forename: Jung Yun
authors.initials: JY
authors.lastname: Choi
mesh_terms: D000293:Adolescent; D000903:Antibiotics, Antineoplastic / Q000009:adverse effects*; D009202:Cardiomyopathies / Q000139:chemically induced / Q000517:prevention & control; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000009:adverse effects*; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000139:chemically induced / Q000517:prevention & control; D006801:Humans; D007223:Infant; D008297:Male; D009369:Neoplasms / Q000188:drug therapy* / Q000401:mortality; D011929:Razoxane / Q000627:therapeutic use*; D016277:Ventricular Function, Left / Q000502:physiology
chemical_list: D000903:Antibiotics, Antineoplastic; D002317:Cardiovascular Agents; D011929:Razoxane; D004317:Doxorubicin
references.citation: Eur J Pediatr. 2005 Nov;164(11):678-84
references.pmid: 16044276
references.citation: Ann Oncol. 2002 Jun;13(6):819-29
references.pmid: 12123328
references.citation: Am J Cardiol. 1982 Apr 1;49(5):1319-23
references.pmid: 7064857
references.citation: Cochrane Database Syst Rev. 2009 Jan 21;(1):CD006647
references.pmid: 19160293
references.citation: J Clin Oncol. 2009 Jan 1;27(1):127-45
references.pmid: 19018081
references.citation: J Clin Oncol. 1996 Feb;14(2):362-72
references.pmid: 8636745
references.citation: Ann Oncol. 2006 Apr;17(4):614-22
references.pmid: 16423847
references.citation: Cancer. 2003 Apr 15;97(8):1991-8
references.pmid: 12673729
references.citation: Cancer Treat Rev. 1999 Aug;25(4):237-47
references.pmid: 10448132
references.citation: J Clin Oncol. 2008 Mar 1;26(7):1106-11
references.pmid: 18309945
references.citation: J Clin Oncol. 1997 Apr;15(4):1544-52
references.pmid: 9193351
references.citation: Pediatr Hematol Oncol. 2008 Jun;25(4):261-81
references.pmid: 18484471
references.citation: J Clin Oncol. 2002 Jun 15;20(12):2895-903
references.pmid: 12065567
references.citation: Circulation. 1980 Nov;62(5):1054-61
references.pmid: 7418156
references.citation: Support Care Cancer. 2006 Feb;14(2):128-36
references.pmid: 16034614
references.citation: Eur J Cancer. 2006 Dec;42(18):3191-8
references.pmid: 16987655
references.citation: Br J Cancer. 2007 Jan 29;96(2):226-30
references.pmid: 17242696
references.citation: Eur J Pediatr. 2007 Nov;166(11):1187-8
references.pmid: 17160688
references.citation: J Clin Oncol. 2001 Jul 1;19(13):3163-72
references.pmid: 11432882
references.citation: Eur J Cancer. 2007 May;43(7):1134-40
references.pmid: 17383867
references.citation: Ann Oncol. 2002 Apr;13(4):503-12
references.pmid: 12056699
references.citation: J Clin Oncol. 1998 Feb;16(2):545-50
references.pmid: 9469339
references.citation: J Clin Oncol. 2007 Feb 10;25(5):493-500
references.pmid: 17290056
references.citation: N Engl J Med. 2004 Jul 8;351(2):145-53
references.pmid: 15247354
references.citation: Drugs. 2005;65(7):1005-24
references.pmid: 15892593
references.citation: J Clin Oncol. 1997 Jan;15(1):61-8
references.pmid: 8996125
references.citation: Cochrane Database Syst Rev. 2008 Apr 16;(2):CD003917
references.pmid: 18425895
references.citation: J Clin Oncol. 2005 Apr 20;23(12):2629-36
references.pmid: 15837978
references.citation: Circulation. 1997 Oct 21;96(8):2641-8
references.pmid: 9355905