TY - JOUR
T1 - Prospective Study of Cardiomyopathy Induced by Adjuvant Doxorubicin Therapy in Patients With Soft-Tissue Sarcomas
AU - Ettinghausen, Stephen E.
AU - Bonow, Robert O.
AU - Palmeri, Sebastian T.
AU - Seipp, Claudia A.
AU - Steinberg, Seth M.
AU - White, Donald E.
AU - Rosenberg, Steven A.
PY - 1986/12
Y1 - 1986/12
N2 - Since a combination of surgery and adjuvant high-dose doxorubicin therapy can prolong survival in patients with extremity sarcomas, but at the expense of significant cardiomyopathic changes, we prospectively studied the differences in cardiotoxicity in 118 patients with sarcomas treated with high- vs low-dose doxorubicin therapy following surgery. Cardiac function, as assessed by left ventricular ejection fraction (EF), was determined by standard radionuclide angiography during rest and exercise. No patients in this study developed congestive heart failure. While both regimens produced net decreases in EF during rest and exercise, the high-dose doxorubicin regimen resulted in significantly greater declines in EF than the low-dose protocol. Of patients with normal baseline values, a greater percentage of patients receiving the high-dose regimen developed an abnormal EF than did those receiving the low-dose regimen, even after separating younger from older individuals. Thus, treatment-induced cardiomyopathy appears to be a significant clinical problem after both high- and low-dose doxorubicin therapy. The use of the low-dose regimen decreases the magnitude of the cardiomyopathic changes.
AB - Since a combination of surgery and adjuvant high-dose doxorubicin therapy can prolong survival in patients with extremity sarcomas, but at the expense of significant cardiomyopathic changes, we prospectively studied the differences in cardiotoxicity in 118 patients with sarcomas treated with high- vs low-dose doxorubicin therapy following surgery. Cardiac function, as assessed by left ventricular ejection fraction (EF), was determined by standard radionuclide angiography during rest and exercise. No patients in this study developed congestive heart failure. While both regimens produced net decreases in EF during rest and exercise, the high-dose doxorubicin regimen resulted in significantly greater declines in EF than the low-dose protocol. Of patients with normal baseline values, a greater percentage of patients receiving the high-dose regimen developed an abnormal EF than did those receiving the low-dose regimen, even after separating younger from older individuals. Thus, treatment-induced cardiomyopathy appears to be a significant clinical problem after both high- and low-dose doxorubicin therapy. The use of the low-dose regimen decreases the magnitude of the cardiomyopathic changes.
UR - http://www.scopus.com/inward/record.url?scp=0022965207&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0022965207&partnerID=8YFLogxK
U2 - 10.1001/archsurg.1986.01400120095016
DO - 10.1001/archsurg.1986.01400120095016
M3 - Article
C2 - 3789915
AN - SCOPUS:0022965207
SN - 0004-0010
VL - 121
SP - 1445
EP - 1451
JO - Archives of surgery
JF - Archives of surgery
IS - 12
ER -