Assessment of efficiency of 3D-STI technology on early myocardial toxicity in patients with TRA treatment after breast cancer surgery
Objective To study the efficiency of 3D-STI technology on trastuzumab (TRA) treatment related early myocardial toxicity.Methods In a retrospective study,120 breast cancer postoperative patients receiving TRA treatment and maintenance therapy in this hospital from January 2020 to December 2022 were selected and conducted the routine ultrasound and 3D-STI technological examinations before chemotherapy,in 2,4,6 cycles of chemotherapy.Follow-up continued until October 2023.The patients were divided into the my-ocardial toxicity group and non-myocardial toxicity group according to whether or not developing myocardial toxicity.By combining with the baseline data,the univariate and multivariate logistic regression were em-ployed to analyze and determine the influencing factors of myocardial toxicity.The predictive value of 3D-STI parameters at different time points for myocardial toxicity was evaluated by using the receiver operating char-acteristic (ROC) curve.Results There was no statistically significant difference in 3D-STI technical parame-ters such as GLS,GAS,GCS and GRS before chemotherapy and in 2 cycles of chemotherapy between the myo-cardial toxicity group and the non-myocardial toxicity group (P>0.05);GLS,GAS and GRS after 4,6 cycles of chemotherapy in the myocardial toxicity group were lower than those in the non-myocardial toxicity group (P<0.05).The logistic regression analysis results showed that GLS (OR=0.542,95％CI:0.424-0.694),GAS (OR=0.580,95％CI:0.360-0.936) and GCS (OR=1.699,95％CI:1.035-2.790) after 4 cycles of chemotherapy,and GLS (OR=0.534,95％CI:0.440-0.648),GAS (OR=0.559,95％CI:0.347-0.901) and GCS (OR=1.613,95％CI:1.131-2.300) after 6 cycles of chemotherapy were the influencing factors of myocardial toxicity in TRA treatment after breast cancer surgery (P<0.05).The results of the ROC curve showed that after 4 cycles of chemotherapy,the diagnostic critical value of GLS was-17.23％ and the area under the curve (AUC) was 0.645 (95％CI:0.541-0.749);the diagnostic critical value of GCS was-19.22％ and AUC was 0.556 (95％CI:0.444-0.668).The GLS diagnostic critical value after 6 cycles of chemotherapy was-17.82％,and AUC was 0.856 (95％CI:0.786-0.927);the GAS diagnostic critical value was-27.17％,and AUC was 0.994 (95％CI:0.983-<1.000);the diagnostic critical value of GCS was-18.38％,and AUC was 0.842 (95％CI:0.771-0.913).Conclusion The 3D-STI parameters in 4,6 cycles of chemotherapy could predict the myocardial toxicity after TRA treatment after breast cancer surgery.
万方数据
维普
