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Radionuclide ejection fraction in doxorubicin cardiotoxicity
Cancer Treatment Reports
|July 1, 1981
Summary
Serial cardiac function monitoring with radionuclide ejection fraction (EF) can prevent doxorubicin cardiotoxicity. Guidelines for assessing risk factors and discontinuing treatment based on EF changes are proposed.
Area of Science:
- Cardiology
- Oncology
- Pharmacology
Background:
- Doxorubicin is a widely used chemotherapy agent associated with cardiotoxicity.
- Early detection of cardiac dysfunction is crucial for managing doxorubicin-induced cardiotoxicity.
- Risk factors for cardiotoxicity include pre-existing cardiovascular disease, mediastinal irradiation, and cumulative doxorubicin dose.
Observation:
- Serial radionuclide ejection fraction (EF) assessments were performed in 292 patients receiving doxorubicin.
- Detailed analysis included 98 patients with varying risk factors (RFs) and cumulative doses.
- Criteria for discontinuing doxorubicin were established based on EF values and changes over time.
Findings:
- No patients in the no-risk-factor (NRF) group met discontinuation criteria or developed cardiac failure.
- In the risk-factor (RF) group, eight patients required doxorubicin discontinuation due to declining EF.
- Discontinuation doses in the RF group varied significantly, ranging from 120 to 730 mg/m2.
Implications:
- Establishing baseline EF and assessing RFs before doxorubicin initiation is recommended.
- Specific monitoring protocols for EF are suggested based on risk factors and initial EF.
- Adherence to these guidelines may mitigate the risk of developing doxorubicin cardiotoxicity.