Prevention of early anthracycline-induced cardiotoxicity in patients with breast cancer
Summary. It is well known that the use of doxorubicin in low cumulative doses (240–450 mg/m2) associated with the risk of myocardial injury, left ventricular diastolic and systolic disorders. The recommendations of the European Society for Medical Oncology (ESMO) is allowed to use angiotensin-converting enzyme (ACE) inhibitors and β-blockers for the prevention of doxorubicin cardiotoxicity. The aim of the study was to assess the safety and efficacy of standardized low dose cardioprotective therapy with ACE inhibitors and β-blockers in patients with stage II and III breast cancer. 100 patients required 6 cycles of a standard anthracycline chemotherapy (as a part of radical program treatment) were enrolled in to the study. In the main study group 50 patients received regime FAC concurrent with the cardioprotective medications (enalapril 2.5 mg orally twice daily and carvedilol 6.25 mg orally twice daily). In control group the same chemo were administered to the 50 patients but without supportive therapy. The comprehensive examination of the cardiovascular system (blood pressure, heart rate, electro- and echocardiography) was done before, during the special treatment and 3 months after the last cycle. It was established that the usage of cardioprotective therapy is safe and significantly reduces the incidence of specific cardiotoxicity of low cumulative doses of doxorubicin, such as Q–Tc interval prolongation and diastolic left ventricular dysfunction type 1.
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