Protective Effects of Dexrazoxane Combined with Creatine Phosphate on Cardiac Injury by Anthracycline in Breast Cancer Patients
Objective:To analyze the prophylactic effects and safety of dexrazoxane combined with sodium creatine phosphate on cardiac toxicity of anthracycline in patients with breast cancer.Methods:A total of 200 female breast cancer patients were divided into control group,group A,B and C according to the random number table,50 cases in each group.Patients in the control group were given AC or EC chemotherapy plan;on the basis of AC or EC plan,patients in group A,B or C were additionally given dexrazoxane,creatine phosphate sodium for injection or both.Three weeks was a cycle of chemotherapy.The risk factors of anthracycline cardiotoxicity were analyzed.The changes of electrocardiogram(ECG),my-ocardial enzymes,serum B-type natriuretic peptide(BNP),cardiac troponin Ⅰ(cTnI),left ventricular ejection fraction(LVEF)and incidence of adverse reactions were observed before and after 3 cycles of chemothera-py.Results:Among the 200 patients,49 patients suffered from cardiotoxicity with the incidence of 24.5％.There was a significant difference in the incidence of cardiac injury among the four groups(P＜0.05).The order of cardiac injury incidence was control group(50.00％)＞group B(24.00％)＞group A(16.00％)＞group C(8.00％).The results of binary Logistic regression analysis showed that cardio protective regimen,chemotherapy cycle number＞3,cumulative dose of anthracycline＞400 mg were associated with cardiac injury(P＜0.05).Chemotherapy cycle number＞3,cumulative dose of anthracycline＞400 mg were indepen-dent risk factors for anthracycline cardiotoxicity,while the use of cardiac protectants was a protective factor.The abnormal rates of ECG in the A,B,C groups were lower than that in the control group(P＜0.05).No statistically significant differences of serum level of CK,CK-MB,BNP or cTnI were found among the groups before treatment(P＞0.05).After chemotherapy,the levels of BNP and cTnI in the control group were significantly higher than those in the test groups(P＜0.05),while there was no significant difference in the incidence of adverse reactions among the groups(P＞0.05).Conclusion:Dexrazoxane combined with creatine phosphate sodium is effective and safe in the treatment of anthracicline induced cardiac damage in patients with breast cancer.
Breast cancerAnthracyclinesCardiotoxicityDexrazoxane for injectionCreatine phosphate sodium for injection
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