Prospective evaluation of doxorubicin-induced cardiomyopathy resulting from postsurgical adjuvant treatment of patients with soft tissue sarcomas

A. Dresdale, R. O. Bonow, R. Wesley, S. T. Palmeri, L. Barr, D. Mathison, T. D'Angelo, S. A. Rosenberg

Research output: Contribution to journalArticle

Abstract

One hundred and one soft tissue sarcoma patients from an adjuvant chemotherapy study of the Surgery Branch, National Cancer Institute who had received ≥ 430 mg/m2 (range, 430-600 mg/m2) of doxorubicin were followed for evidence of cardiomyopathy. Fourteen patients developed clinical congestive heart failure attributable to doxorubicin. Nine of these fourteen were evaluated by radionuclide angiography (RNA), and all were abnormal with mean ejection fraction both at rest and exercise <30%. Sixty-one asymptomatic patients were studied at least once with RNA. In this asymptomatic group, 13 of 61 patients (21%) had abnormal resting left ventricular function. Exercise studies identified an additional 19 abnormal individuals (31%). Overall incidence of cardiomyopathy, as evidenced by RNA, in the asymptomatic group was 52%. By including the fourteen symptomatic patients, the incidence of cardiomyopathy detected either clinically or by RNA in the 75 evaluated patients was 46%. Comparison of patients by age (<40 versus > 40) revealed a highly significant difference in the incidence of cardiomyopathy (P <.001). Fourteen of 36 patients (38%) ≤ 40 had either clinical or RNA evidence of cardiotoxicity while 32 of 39 (82%) individuals > 40 demonstrated cardiomyopathy. No significant difference was seen in those asymptomatic patients in whom RNA was performed ≤ 12 months as compared with > 12 months after the end of doxorubicin treatment. In the entire group there was no apparent improvement in cardiomyopathy with time, but results suggest that left ventricular function in the group older than 40 years does deteriorate. The cardiac function of patients younger than age 40 appeared to remain stable or possibly improve with time after the completion of treatment. Sex, tumor location, and radiation treatment were not associated with an increased risk of cardiomyopathy. These results emphasize the dangers of full-dose doxorubicin therapy. This high incidence of cardiomyopathy became apparent because of our ability to prospectively evaluate a large group of patients with prolonged life expectancy that received adjuvant doxorubicin chemotherapy after surgery.

Original languageEnglish (US)
Pages (from-to)51-60
Number of pages10
JournalCancer
Volume52
Issue number1
StatePublished - 1983
Externally publishedYes

Fingerprint

Cardiomyopathies
Sarcoma
Doxorubicin
Radionuclide Angiography
Adjuvant Chemotherapy
Therapeutics
National Cancer Institute (U.S.)
Incidence
Life Expectancy
Left Ventricular Function
Heart Failure
Exercise
Radiation
Neoplasms

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Dresdale, A., Bonow, R. O., Wesley, R., Palmeri, S. T., Barr, L., Mathison, D., ... Rosenberg, S. A. (1983). Prospective evaluation of doxorubicin-induced cardiomyopathy resulting from postsurgical adjuvant treatment of patients with soft tissue sarcomas. Cancer, 52(1), 51-60.

Prospective evaluation of doxorubicin-induced cardiomyopathy resulting from postsurgical adjuvant treatment of patients with soft tissue sarcomas. / Dresdale, A.; Bonow, R. O.; Wesley, R.; Palmeri, S. T.; Barr, L.; Mathison, D.; D'Angelo, T.; Rosenberg, S. A.

In: Cancer, Vol. 52, No. 1, 1983, p. 51-60.

Research output: Contribution to journalArticle

Dresdale, A, Bonow, RO, Wesley, R, Palmeri, ST, Barr, L, Mathison, D, D'Angelo, T & Rosenberg, SA 1983, 'Prospective evaluation of doxorubicin-induced cardiomyopathy resulting from postsurgical adjuvant treatment of patients with soft tissue sarcomas', Cancer, vol. 52, no. 1, pp. 51-60.
Dresdale, A. ; Bonow, R. O. ; Wesley, R. ; Palmeri, S. T. ; Barr, L. ; Mathison, D. ; D'Angelo, T. ; Rosenberg, S. A. / Prospective evaluation of doxorubicin-induced cardiomyopathy resulting from postsurgical adjuvant treatment of patients with soft tissue sarcomas. In: Cancer. 1983 ; Vol. 52, No. 1. pp. 51-60.
@article{7e3a25be96484e1e916f2d83d7df9041,
title = "Prospective evaluation of doxorubicin-induced cardiomyopathy resulting from postsurgical adjuvant treatment of patients with soft tissue sarcomas",
abstract = "One hundred and one soft tissue sarcoma patients from an adjuvant chemotherapy study of the Surgery Branch, National Cancer Institute who had received ≥ 430 mg/m2 (range, 430-600 mg/m2) of doxorubicin were followed for evidence of cardiomyopathy. Fourteen patients developed clinical congestive heart failure attributable to doxorubicin. Nine of these fourteen were evaluated by radionuclide angiography (RNA), and all were abnormal with mean ejection fraction both at rest and exercise <30{\%}. Sixty-one asymptomatic patients were studied at least once with RNA. In this asymptomatic group, 13 of 61 patients (21{\%}) had abnormal resting left ventricular function. Exercise studies identified an additional 19 abnormal individuals (31{\%}). Overall incidence of cardiomyopathy, as evidenced by RNA, in the asymptomatic group was 52{\%}. By including the fourteen symptomatic patients, the incidence of cardiomyopathy detected either clinically or by RNA in the 75 evaluated patients was 46{\%}. Comparison of patients by age (<40 versus > 40) revealed a highly significant difference in the incidence of cardiomyopathy (P <.001). Fourteen of 36 patients (38{\%}) ≤ 40 had either clinical or RNA evidence of cardiotoxicity while 32 of 39 (82{\%}) individuals > 40 demonstrated cardiomyopathy. No significant difference was seen in those asymptomatic patients in whom RNA was performed ≤ 12 months as compared with > 12 months after the end of doxorubicin treatment. In the entire group there was no apparent improvement in cardiomyopathy with time, but results suggest that left ventricular function in the group older than 40 years does deteriorate. The cardiac function of patients younger than age 40 appeared to remain stable or possibly improve with time after the completion of treatment. Sex, tumor location, and radiation treatment were not associated with an increased risk of cardiomyopathy. These results emphasize the dangers of full-dose doxorubicin therapy. This high incidence of cardiomyopathy became apparent because of our ability to prospectively evaluate a large group of patients with prolonged life expectancy that received adjuvant doxorubicin chemotherapy after surgery.",
author = "A. Dresdale and Bonow, {R. O.} and R. Wesley and Palmeri, {S. T.} and L. Barr and D. Mathison and T. D'Angelo and Rosenberg, {S. A.}",
year = "1983",
language = "English (US)",
volume = "52",
pages = "51--60",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "1",

}

TY - JOUR

T1 - Prospective evaluation of doxorubicin-induced cardiomyopathy resulting from postsurgical adjuvant treatment of patients with soft tissue sarcomas

AU - Dresdale, A.

AU - Bonow, R. O.

AU - Wesley, R.

AU - Palmeri, S. T.

AU - Barr, L.

AU - Mathison, D.

AU - D'Angelo, T.

AU - Rosenberg, S. A.

PY - 1983

Y1 - 1983

N2 - One hundred and one soft tissue sarcoma patients from an adjuvant chemotherapy study of the Surgery Branch, National Cancer Institute who had received ≥ 430 mg/m2 (range, 430-600 mg/m2) of doxorubicin were followed for evidence of cardiomyopathy. Fourteen patients developed clinical congestive heart failure attributable to doxorubicin. Nine of these fourteen were evaluated by radionuclide angiography (RNA), and all were abnormal with mean ejection fraction both at rest and exercise <30%. Sixty-one asymptomatic patients were studied at least once with RNA. In this asymptomatic group, 13 of 61 patients (21%) had abnormal resting left ventricular function. Exercise studies identified an additional 19 abnormal individuals (31%). Overall incidence of cardiomyopathy, as evidenced by RNA, in the asymptomatic group was 52%. By including the fourteen symptomatic patients, the incidence of cardiomyopathy detected either clinically or by RNA in the 75 evaluated patients was 46%. Comparison of patients by age (<40 versus > 40) revealed a highly significant difference in the incidence of cardiomyopathy (P <.001). Fourteen of 36 patients (38%) ≤ 40 had either clinical or RNA evidence of cardiotoxicity while 32 of 39 (82%) individuals > 40 demonstrated cardiomyopathy. No significant difference was seen in those asymptomatic patients in whom RNA was performed ≤ 12 months as compared with > 12 months after the end of doxorubicin treatment. In the entire group there was no apparent improvement in cardiomyopathy with time, but results suggest that left ventricular function in the group older than 40 years does deteriorate. The cardiac function of patients younger than age 40 appeared to remain stable or possibly improve with time after the completion of treatment. Sex, tumor location, and radiation treatment were not associated with an increased risk of cardiomyopathy. These results emphasize the dangers of full-dose doxorubicin therapy. This high incidence of cardiomyopathy became apparent because of our ability to prospectively evaluate a large group of patients with prolonged life expectancy that received adjuvant doxorubicin chemotherapy after surgery.

AB - One hundred and one soft tissue sarcoma patients from an adjuvant chemotherapy study of the Surgery Branch, National Cancer Institute who had received ≥ 430 mg/m2 (range, 430-600 mg/m2) of doxorubicin were followed for evidence of cardiomyopathy. Fourteen patients developed clinical congestive heart failure attributable to doxorubicin. Nine of these fourteen were evaluated by radionuclide angiography (RNA), and all were abnormal with mean ejection fraction both at rest and exercise <30%. Sixty-one asymptomatic patients were studied at least once with RNA. In this asymptomatic group, 13 of 61 patients (21%) had abnormal resting left ventricular function. Exercise studies identified an additional 19 abnormal individuals (31%). Overall incidence of cardiomyopathy, as evidenced by RNA, in the asymptomatic group was 52%. By including the fourteen symptomatic patients, the incidence of cardiomyopathy detected either clinically or by RNA in the 75 evaluated patients was 46%. Comparison of patients by age (<40 versus > 40) revealed a highly significant difference in the incidence of cardiomyopathy (P <.001). Fourteen of 36 patients (38%) ≤ 40 had either clinical or RNA evidence of cardiotoxicity while 32 of 39 (82%) individuals > 40 demonstrated cardiomyopathy. No significant difference was seen in those asymptomatic patients in whom RNA was performed ≤ 12 months as compared with > 12 months after the end of doxorubicin treatment. In the entire group there was no apparent improvement in cardiomyopathy with time, but results suggest that left ventricular function in the group older than 40 years does deteriorate. The cardiac function of patients younger than age 40 appeared to remain stable or possibly improve with time after the completion of treatment. Sex, tumor location, and radiation treatment were not associated with an increased risk of cardiomyopathy. These results emphasize the dangers of full-dose doxorubicin therapy. This high incidence of cardiomyopathy became apparent because of our ability to prospectively evaluate a large group of patients with prolonged life expectancy that received adjuvant doxorubicin chemotherapy after surgery.

UR - http://www.scopus.com/inward/record.url?scp=0020576030&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0020576030&partnerID=8YFLogxK

M3 - Article

C2 - 6850545

AN - SCOPUS:0020576030

VL - 52

SP - 51

EP - 60

JO - Cancer

JF - Cancer

SN - 0008-543X

IS - 1

ER -