Effect at One Year of Adjuvant Trastuzumab for HER2+ Breast Cancer Combined with Radiation or an Anthracycline on Left Ventricular Ejection Fraction
| Autor: | Jennifer H. Jordan, Ralph B. D'Agostino, Sujethra Vasu, Alexandra Thomas, Doris R. Brown, Heidi D. Klepin, Jessie Bowers, D.N. Ayala-Peacock, Mousumi M. Andersen, W. Gregory Hundley, Banks W. Kooken |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Anthracycline Adjuvant chemotherapy Receptor ErbB-2 medicine.medical_treatment Breast Neoplasms 030204 cardiovascular system & hematology Article 03 medical and health sciences 0302 clinical medicine Breast cancer Antineoplastic Agents Immunological Trastuzumab Risk Factors Internal medicine medicine Humans Anthracyclines Ejection fraction business.industry Stroke Volume Middle Aged medicine.disease Radiation therapy Cardiovascular Diseases Chemotherapy Adjuvant 030220 oncology & carcinogenesis Concomitant Cardiology Female Cardiology and Cardiovascular Medicine business Adjuvant medicine.drug |
| Zdroj: | Am J Cardiol |
| Popis: | To determine the impact of radiation therapy (XRT) in addition to trastuzumab (TZB) adjuvant chemotherapy for HER2+ breast cancer on left ventricular systolic function, we assessed demographics, oncologic treatment history including XRT exposure, and serial measurements of left ventricular ejection fraction (LVEF) in 135 consecutively identified women receiving TZB for treatment of adjuvant breast cancer. Longitudinal mixed effects models were fit to identify baseline to treatment changes in LVEF among those receiving TZB with or without concomitant anthracycline or XRT. Women averaged 53 ± 3 years in age, 77% were white, 62% patients had 1 or more cardiovascular risk factors at baseline, and mean duration of TZB was 11 ± 5 months. Seventy-seven women were treated with XRT and received between 4000 and 5500 cGy of radiation. The LVEF declined by an average of 3.4% after 1 year for those in the study. Relative to baseline upon completion of adjuvant TZB, LVEF remained reduced for those receiving anthracycline with or without XRT (p=0.002 for both), or XRT alone (p=0.002), but not in those without these therapies. Amongst patients treated only with XRT and TZB, LVEF declined 3.1% on average in those with left-sided disease and 6.9% on average in those with right-sided disease (p= 0.06, p= 0.008 respectively). Among women receiving TZB for adjuvant treatment of HER-2 positive breast cancer, the administration of XRT, anthracycline, or the combination of the 2 is associated with a persistent post-treatment as opposed to a temporary treatment related decline in LVEF. |
| Databáze: | OpenAIRE |
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