表阿霉素大剂量持续静滴对心脏毒性反应的观察

目的:观察表阿霉素大剂量持续静滴化疗的心脏毒性和安全性。方法:147例无心脏疾患的乳腺癌术后辅助化疗患者,按照病理分期应用常规剂量和方法化疗(Ⅱ期,对照组)及表阿霉素大剂量持续静滴化疗(Ⅲ期,观察组),连续6个周期,第2,4,6周期末和化疗后第3、6个月分别检查心电图、心功能评价和心脏超声检查心脏射血分数。观察组表阿霉素应用80mg/m2,持续24h静滴。结果:化疗第2周期末,心脏毒性反应几乎未发生。第4周期末开始,心脏毒性反应的发生率明显增加,并随着治疗周期的延长而增加。化疗停药后患者的心脏毒性逐渐下降,心功能恢复。观察组患者发生率的绝对值明显高于对照组,但两组间未见有统计学差异(p>0.05)。结论:表阿霉素大剂量持续静滴化疗的心脏毒性与常规剂量使用方法相当,安全性较高,患者能耐受。

Observation of cardiotoxicity induced by continuous intravenous infusion of high-dose epirubicin

Objective: To observe cardiotoxicity and safety of high-dose epirubicin by continuous intravenous infusion. Methods: 147 women with no existing heart problems received chemotherapy after breast cancer resection. They were treated with epirubicin in combination with other antineoplastics-24-hour continuous intravenous infusion of high-dose epirubicin for observation group (80 mg per m2 body-surface)and intravenous injection of its low-dose for control group (40 mg per m2 body-surface)-once every 3 weeks as a course for 6 consecutive courses. Cardiac function was carefully monitored with electrocardiography and contrast echocardiography before and after treatment at the end of the second-fourth-sixth courses and the third and sixth months. Results: Cardiotoxicity didn't occure until at the end of the fourth course. Its incidence was increased with time-more in observation group than in control group but with no statistical difference between them. Conclusion: High-dose epirubicin administered by continuous intravenous infusion is safe and the resultant cardiotoxicity is much the same as one caused by usual doses of the drug. Patients showed tolerance to epirubicin.