Cardiac monitoring during adjuvant trastuzumab therapy: Guideline adherence in clinical practice.

Autor: Visser A; a Department of Medical Psychology , Radboud university medical center , Nijmegen , The Netherlands., van de Ven EM; b Department of Medical Oncology , Radboud university medical center , Nijmegen , The Netherlands., Ruczynski LI; b Department of Medical Oncology , Radboud university medical center , Nijmegen , The Netherlands., Blaisse RJ; c Department of Medical Oncology , Rijnstate, Arnhem , The Netherlands., van Halteren HK; d Department of Medical Oncology , Gelderse Vallei, Ede , The Netherlands., Aben K; e Comprehensive Cancer Centre The Netherlands , Utrecht , The Netherlands.; f Department for Health Evidence , Radboud university medical center , Nijmegen , The Netherlands., van Laarhoven HW; b Department of Medical Oncology , Radboud university medical center , Nijmegen , The Netherlands.; g Department of Medical Oncology , Academic Medical Center, University of Amsterdam , Amsterdam , The Netherlands.
Jazyk: angličtina
Zdroj: Acta oncologica (Stockholm, Sweden) [Acta Oncol] 2016; Vol. 55 (4), pp. 423-9. Date of Electronic Publication: 2015 Jul 28.
DOI: 10.3109/0284186X.2015.1068444
Abstrakt: Background: Cardiotoxicity is an important adverse effect of adjuvant breast cancer treatment with trastuzumab and three monthly left ventricular ejection fraction (LVEF) monitoring is considered mandatory. The purpose of this study was to gain insight into LVEF monitoring during adjuvant trastuzumab treatment in clinical practice.
Material and Methods: In a multicenter retrospective study encompassing 328 patients, of which 171 patients were actually treated with trastuzumab, we analyzed the frequency and mode of LVEF monitoring and compared it with LVEF monitoring guidelines.
Results: The results indicated poor guideline adherence. In 9% of patients trastuzumab was started in spite of a low LVEF (< 55%). In 24% of patients no valid baseline LVEF value was available. LVEF measurements during treatment at three, six and 12 months were only performed in, respectively, 53%, 40% and 30% of patients.
Conclusion: A significant proportion of patients are treated with trastuzumab, while LVEF monitoring is not adequately performed. More attention should be paid to the implementation of (cardiac assessment) guidelines in clinical practice.
Databáze: MEDLINE
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