Asymptomatic reductions in cardiac function are common in breast cancer patients treated with doxorubicin. NT-proBNP may serve as a convenient serum biomarker for the early detection of cardiotoxicity induced by anthracycline.
Background: Cardiac dysfunction is one of the major limitations of anthracycline treatment in cancer patients. Current reliable investigation to detect early cardiac damage from anthracycline is not available. There are several serum cardiac markers useful in other types of cardiomyopathy including NT-pro BNP, Troponin-T, and CK-MB. We chose to investigate potential application of these serum biomarkers in the cancer patients receiving anthracycline.Patients and methods: We prospectively collected data from a cohort of 52 female breast cancer patients who receiving doxorubicin and cyclophosphamide (AC) regimen every 3 weeks for 4 cycles for preoperative or postoperative adjuvant treatment. Cardiac function evaluations by echocardiography were done at baseline and post 4th cycle chemotherapy. Patients' blood samplings were serially measured for cardiac biomarkers at baseline, after 1st cycle, and after 4th cycle chemotherapy.Results: All patients were in good performance status with ECOG scale 0-1.The mean cumulative dose of doxorubicin in this study was 236.69 mg/m2. There was no symptomatic heart failure detected during study period. However, there were significant asymptomatic reductions of left ventricular ejection fraction (LVEF) from 70.73 ± 5.97% at baseline to 66.96 ± 5.48% (p<0.001). The severities of LVEF declination were 17.4% in grade1 and 3.8% in grade 2 by clinical toxicity criteria of NCI version 2. We found significant elevation of serum NT-proBNP (p = 0.044) following the first dose of chemotherapy when compared the measurements in patients who had reduction of LVEF to those with normal LVEF. Measurement of serum Troponin-T and CK-MB showed no significant correlation with changes in LVEF. Generalized-estimating-equations correlation analysis demonstrated that the reduction of fractional shortening (FS) was significantly associated with the elevation NT-pro BNP (r = -0.016, p = 0.014). At cutoff level 45 pg/mL, serum NT-proBNP had 100% sensitivity and 66.67% specificity for the detection of cardiotoxicity in patients under 50 year-old.Conclusion: Asymptomatic reductions in cardiac function are common in patients treated with doxorubicin. NT-pro BNP may serve as a potential convenient serum biomarker for early detection of cardiotoxicity induced by anthracycline. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 4003.
Objective: The objective of the study was to determine the survival of patients with small-cell lung cancer treated at tertiary hospitals in the East of Thailand. Materials and methods: The researchers conducted this retrospective study by reviewing medical records of patients with small-cell lung cancer treated at Chonburi Cancer Hospital and Prapokklao Hospital from January 2007 to December 2016 and monitored via follow-up until December 2018. Results: This study enrolled 54 patients with a median follow-up time of 8.5 months. The median age of patients was 63 years old. Most patients were male (83.3%) and had a history of smoking (90.7%), and 31.4% had clinical superior vena cava obstruction at initial treatment. The Eastern Cooperative Oncology Group performance status 0-1 was noted for 61.1% of the study population. Median survival time of patients with limited-stage and extensive-stage small cell lung cancer who received systemic chemotherapy and/or radiotherapy was 17.01 months (95% CI, 12.01 -22.01) and 8.14 months (95% CI, 7.19 -9.10), respectively, and that of patients receiving supportive care was 2.3 months (95% CI, 0.75 -4.03). However, the median survival time of patients with extensive-stage small-cell lung cancer receiving only palliative chemotherapy was 5.9 months (95% CI, 0.32 -17.51). Conclusions: The median survival time of patients with limited-stage small-cell lung cancer treated in the East of Thailand was comparable to those of landmark studies; however, the survival of patients with extensive-stage small-cell lung cancer was shorter than those of Phase III trials. A multidisciplinary team was necessary to improve the quality of patient care.
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