右丙亚胺在应用蒽环类药物乳腺癌患者中的疗效观察  

Curative effect of dexrazoxane in patients with breast cancer treated with anthracyclines

作　　者：栾晓东[1] 盖延红[2] 万越[1] 侯红[1] 慕强[1] 王启堂[1] 

机构地区：[1]青岛大学医学院第二附属医院乳腺外科,青岛266042 [2]青岛大学医学院第二附属医院心内科

出　　处：《中国循证心血管医学杂志》2015年第4期482-483,486,共3页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的观察右丙亚胺在应用蒽环类药物的乳腺癌患者心脏毒性的防治效果以及对蒽环类药物抗肿瘤效果的影响。方法对101例应用含蒽环类(表阿霉素)方案化疗的患者,分为全程应用右丙亚胺加化疗组(6个化疗周期),半程(后3个化疗周期)应用右丙亚胺加化疗组,观察比较两组患者心电图异常、超敏肌钙蛋白、脑钠肽、心脏超声的左室舒张末期容积以及1年后肿瘤复发率指标。结果随访1年时,右丙亚胺全程应用组心电图异常发生率、血清超敏肌钙蛋白及脑钠肽水平均低于右亚丙胺半程应用组,差异均有统计学意义(P<0.05)。两组左室舒张末期容积及1年无肿瘤复发率无统计学差异(P>0.05)。结论对使用蒽环类药物化疗的乳腺癌患者全程应用右亚丙胺比半程应用对心脏的毒性有明显的防治作用,并且右亚丙胺对蒽环类药物的抗肿瘤作用无显著影响。Objective To observe the curative effect of dexrazoxane （DRZ） on cardiotoxicity and its influence on anti-cancer drugs in patients with breast cancer treated with anthracyclines. Methods The patients （n=101） treated with anthracyclines （epirubicin） chemotherapy plan were divided into whole-course DRZ＋chemotherapy group （whole-course group with 6 chemotherapy cycles） and half-course DRZ＋chemotherapy group （half-course group with later 3 chemotherapy cycles）. The changes of electrocardiogram （ECG）, sensitive troponin I （TNI）, brain natriuretic peptide （BNP）, left ventricular end-diastolic volume （LVEDV）, and tumor recurrent rate after 1 year were observed and compared between 2 groups. Results The incidence of abnormal ECG and levels of TNI and BNP were lower in whole-course group than those in half-course group after 1 y （P〈0.05）. LVEDV and tumor recurrent rate after 1 year had no statistical difference between 2 groups （P〉0.05）. Conclusion The whole-course administration of DRZ has significant preventive effect on cardiotoxicity compared with half-course administration, and DRZ has no significant influence on anti-tumor effect of anthracyclines in patients with breast cancer treated with anthracyclines.

关 键 词：右丙亚胺 乳腺癌 蒽环类药物 心脏毒性 

分 类 号：R655.8[医药卫生—外科学]