Prospective Study of Cardiomyopathy Induced by Adjuvant Doxorubicin Therapy in Patients With Soft-Tissue Sarcomas

Stephen E. Ettinghausen, Robert O. Bonow, Sebastian T. Palmeri, Claudia A. Seipp, Seth M. Steinberg, Donald E. White, Steven A. Rosenberg

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1445-1451
Number of pages7
JournalArchives of Surgery
Volume121
Issue number12
DOIs
StatePublished - 1986
Externally publishedYes

Fingerprint

Cardiomyopathies
Sarcoma
Doxorubicin
Prospective Studies
Exercise
Radionuclide Angiography
Therapeutics
Stroke Volume
Reference Values
Extremities
Heart Failure
Survival

ASJC Scopus subject areas

  • Surgery

Cite this

Ettinghausen, S. E., Bonow, R. O., Palmeri, S. T., Seipp, C. A., Steinberg, S. M., White, D. E., & Rosenberg, S. A. (1986). Prospective Study of Cardiomyopathy Induced by Adjuvant Doxorubicin Therapy in Patients With Soft-Tissue Sarcomas. Archives of Surgery, 121(12), 1445-1451. https://doi.org/10.1001/archsurg.1986.01400120095016

Prospective Study of Cardiomyopathy Induced by Adjuvant Doxorubicin Therapy in Patients With Soft-Tissue Sarcomas. / Ettinghausen, Stephen E.; Bonow, Robert O.; Palmeri, Sebastian T.; Seipp, Claudia A.; Steinberg, Seth M.; White, Donald E.; Rosenberg, Steven A.

In: Archives of Surgery, Vol. 121, No. 12, 1986, p. 1445-1451.

Research output: Contribution to journalArticle

Ettinghausen, SE, Bonow, RO, Palmeri, ST, Seipp, CA, Steinberg, SM, White, DE & Rosenberg, SA 1986, 'Prospective Study of Cardiomyopathy Induced by Adjuvant Doxorubicin Therapy in Patients With Soft-Tissue Sarcomas', Archives of Surgery, vol. 121, no. 12, pp. 1445-1451. https://doi.org/10.1001/archsurg.1986.01400120095016
Ettinghausen, Stephen E. ; Bonow, Robert O. ; Palmeri, Sebastian T. ; Seipp, Claudia A. ; Steinberg, Seth M. ; White, Donald E. ; Rosenberg, Steven A. / Prospective Study of Cardiomyopathy Induced by Adjuvant Doxorubicin Therapy in Patients With Soft-Tissue Sarcomas. In: Archives of Surgery. 1986 ; Vol. 121, No. 12. pp. 1445-1451.
@article{b62cc72fd4eb45b6ac94754dfa4a0942,
title = "Prospective Study of Cardiomyopathy Induced by Adjuvant Doxorubicin Therapy in Patients With Soft-Tissue Sarcomas",
abstract = "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.",
author = "Ettinghausen, {Stephen E.} and Bonow, {Robert O.} and Palmeri, {Sebastian T.} and Seipp, {Claudia A.} and Steinberg, {Seth M.} and White, {Donald E.} and Rosenberg, {Steven A.}",
year = "1986",
doi = "10.1001/archsurg.1986.01400120095016",
language = "English (US)",
volume = "121",
pages = "1445--1451",
journal = "JAMA Surgery",
issn = "2168-6254",
publisher = "American Medical Association",
number = "12",

}

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

Y1 - 1986

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

VL - 121

SP - 1445

EP - 1451

JO - JAMA Surgery

JF - JAMA Surgery

SN - 2168-6254

IS - 12

ER -