Dexrazoxane for preventing anthracycline cardiotoxicity in children with solid tumors.
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.
Choi
Hyoung Soo
HS
Department of Pediatrics, Seoul National University Bundang Hospital, Sungnam, Korea.
Park
Eun Sil
ES
Kang
Hyoung Jin
HJ
Shin
Hee Young
HY
Noh
Chung Il
CI
Yun
Yong Soo
YS
Ahn
Hyo Seop
HS
Choi
Jung Yun
JY
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
D000903:Antibiotics, Antineoplastic; D002317:Cardiovascular Agents; D011929:Razoxane; D004317:Doxorubicin
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