Retrospective analysis of cardiovascular diseases related to chemotherapies for advanced solid tumor patients.
Appropriate management of cardiovascular diseases (CVDs) related to chemotherapy for solid tumors is important for safe oncologic treatment. However, prediction of the onset and progression of CVDs has not generally been established in Japan. We carried out a retrospective analysis of advanced or recurrent solid tumor patients who received chemotherapies in a single institution. Patient characteristics, chemotherapy regimens, adverse events, CVDs before chemotherapy, and diagnosis of CVDs in association with chemotherapy were assessed. During the period from April 2006 to March 2012, 394 patients were examined. Cardiac diseases (CDs), hypertension (HT), or arterial thrombosis or venous thromboembolism were prevalent in 37 (9.4%), 22 (5.6%), five (1.3%), and 14 (3.5%) cases, respectively. HT (14.5%) and venous thrombosis (5.8%) were frequent in patients who received bevacizumab-containing chemotherapy. Four cases with left ventricular dysfunction experienced a decrease of ejection fraction and early filling/atrial filling (E/A) and E/A tended to decrease before ejection fraction. Ninety (62.1%) of 145 cases showed an increase in the D-dimer (DD) level before chemotherapy, and a further increase in DD level was found when venous thrombosis occurred. Relative risks of the disease progression of HT, CD, and thromboembolism because of chemotherapy were 1.3, 1.9, and 3.6, respectively. A decrease in E/A and an increase in DD were suggested to be valuable for early diagnosis of the respective onsets of left ventricular dysfunction and venous thrombosis related to chemotherapy. We conclude that patients with previous CD tend to have disease progression of CD during chemotherapy.
aDepartment of Oncology, Miyazaki Prefectural Miyazaki Hospital, Miyazaki bDepartment of Internal Medicine, Kyushu University Beppu Hospital, Oita cDepartment of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences dDepartment of Medical Oncology, National Kyushu Medical Center eDepartment of Comprehensive Clinical Oncology, Faculty of Medical Sciences, Kyushu University fDepartment of Medical Oncology, Fukuoka Wajiro Hospital, Fukuoka, Japan.
Tsuyoshi
T
Shirakawa
Michitaka
M
Nakano
Kenta
K
Nio
Shingo
S
Tamura
Masato
M
Komoda
Hozumi
H
Kumagai
Keita
K
Uchino
Keita
K
Odashiro
Shuji
S
Arita
Yoshihiro
Y
Shibata
Hiroshi
H
Ariyama
Hitoshi
H
Kusaba
Koichi
K
Akashi
Eishi
E
Baba
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D002318:Cardiovascular Diseases / Q000139:chemically induced / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy* / Q000453:epidemiology* / Q000473:pathology; D012189:Retrospective Studies; D055815:Young Adult