An analysis of factors influencing cardiotoxicity in patients with HER-2-positive breast cancer induced by trastuzumab plus chemotherapy
Objective:To investigate the factors influencing cardiotoxicity in human epidermal growth factor receptor 2(HER-2)-positive breast cancer patients induced by trastuzumab combined with chemotherapy.Methods:A total of 152 patients with HER-2-positive breast cancer diagnosed and treated in Xuzhou Central Hospital from December 2020 to December 2022 were selected as the study subjects.All the patients were treated with trastuzumab plus chemotherapy(AC→PH)regimen.Ultrasound was used to monitor cardiac function every 3 months during treatment,and the incidence of cardiotoxicity was recorded.Clinical data of the patients was collected,including age,body mass index,tumor stage,complications(hypertension,diabetes,hyperlipidemia),estrogen receptor(ER)/progesterone receptor(PR)expression,smoking history,drinking history,concurrent radiotherapy and dextropropimide use.The risk factors of cardiotoxicity were analyzed by univariate analysis and multivariate logistic regression.Results:Among the 152 patients,the incidence of cardiotoxicity was 26.31％.The common ECG changes in patients with cardiotoxicity included T-wave changes,sinus bradycardia/tachycardia,and ST segment abnormalities.Univariate analysis showed that not less than 60 years old,complicated with hypertension,complicated with hyperlipidemia,concurrent radiotherapy,combined use of dexrazoxane were the influencing factors of cardiotoxicity(P＜0.05).Multivariate logistic regression analysis showed that age(95％CI:2.429-5.135),complicated with hypertension(95％CI:1.625-3.962),complicated with hyperlipidemia(95％CI:2.054-5.362),concurrent radiotherapy(95％CI:1.759-4.637)were risk factors for cardiotoxicity due to trastuzumab plus chemotherapy in patients of breast cancer with positive HER-2(P＜0.05),while the combination of dexrazoxane(95％CI:3.772-6.015)significantly reduced the incidence of cardiotoxicity(P＜0.05).Conclusion:Not less than 60 years old,complicated with hypertension or hyperlipidemia,and concurrent radiotherapy are risk factors for cardiotoxicity in patients with HER-2-positive breast cancer,while the use of dexrazoxane is a protective factor.During trastuzumab-based chemotherapy,patients not less than 60 years old,complicated with hypertension or hyperlipidemia,undergoing radiotherapy should be considered as the key population for prevention and treatment of cardiotoxicity.Combined application of dexrazoane can help reduce the occurrence of cardiotoxicity.
TrastuzumabChemotherapyHER-2-positive breast cancerCardiotoxicityFactor analysis
万方数据
维普
