Department of Medicine, Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada.
Clin Breast Cancer. 2012 Feb;12(1):4-9. doi: 10.1016/j.clbc.2011.07.006. Epub 2011 Dec 6.
This population-based study of women diagnosed with early-stage breast cancer aimed to (i) determine the current utilization pattern of multigated acquisition (MUGA) scans before adjuvant chemotherapy (AdjC) treatment, and (ii) examine the impact of MUGA scan results on AdjC decision making.
All women who underwent curative-intent surgery for stage I-III breast cancer between October 2005 and September 2006 in Nova Scotia, Canada, were identified through the provincial cancer registry. A retrospective chart review was performed to abstract all relevant clinical-pathologic variables, including baseline cardiac risk factors. The association between MUGA scan utilization and clinical-pathologic variables, as well as receipt and type of AdjC, was examined through univariate and multivariate analyses.
The study included 593 women, of whom 238 (40%) received AdjC (94% anthracycline vs. 6% nonanthracycline) and 198 (33%) underwent baseline MUGA scans. Of those received AdjC, 80% underwent MUGA scans. MUGA scan utilization was associated with AdjC treatment (yes vs. no; P < .0001), Her-2/neu status (positive vs. negative vs. not tested; P < .0001), and AdjC regimen (anthracycline vs. nonanthracycline; P < .0001). Abnormal MUGA results were observed in 5 (2.5%) of 198; all were smokers, and 4 were >65 years of age. In the 1 patient <50 years old, subsequent echocardiograms indicated normal cardiac function.
Routine baseline MUGA scans before AdjC were abnormal and changed the AdjC treatment decision in only 2.5% and 2.0% of patients, respectively. Routine MUGA scans before anthracycline-based AdjC without trastuzumab, however, did not influence AdjC decisions for younger patients <65 years of age without underlying cardiac risk factors.
本项基于人群的研究纳入了诊断为早期乳腺癌的女性，旨在：（i）确定在接受辅助化疗（AdjC）治疗前多门控采集（MUGA）扫描的当前应用模式；（ii）检查 MUGA 扫描结果对 AdjC 决策的影响。
通过省级癌症登记处，确定了 2005 年 10 月至 2006 年 9 月期间在加拿大新斯科舍省接受根治性手术治疗的 I 期至 III 期乳腺癌女性。通过回顾性图表审查，提取所有相关的临床病理变量，包括基线心脏危险因素。通过单变量和多变量分析，研究了 MUGA 扫描的使用与临床病理变量，以及 AdjC 的使用和类型之间的关联。
该研究纳入了 593 名女性，其中 238 名（40%）接受了 AdjC（94%阿霉素类药物 vs. 6%非阿霉素类药物），198 名（33%）接受了基线 MUGA 扫描。在接受 AdjC 的患者中，80%接受了 MUGA 扫描。MUGA 扫描的使用与 AdjC 治疗（是 vs. 否；P<.0001）、HER2/neu 状态（阳性 vs. 阴性 vs. 未检测；P<.0001）和 AdjC 方案（阿霉素类药物 vs. 非阿霉素类药物；P<.0001）相关。在 198 名接受 MUGA 扫描的患者中，有 5 名（2.5%）患者的扫描结果异常。所有异常患者均为吸烟者，且 4 名患者年龄>65 岁。在年龄<50 岁的 1 名患者中，随后的超声心动图显示心功能正常。
在接受阿霉素类药物为基础的 AdjC 治疗前，常规进行基线 MUGA 扫描结果异常，且仅分别有 2.5%和 2.0%的患者改变了 AdjC 治疗决策。然而，对于无心脏危险因素的年龄<65 岁的年轻患者，如果不使用曲妥珠单抗，则常规进行 MUGA 扫描不会影响 AdjC 决策。
