Departments of *Obstetric and Gynecology ‡Quality Management, Greenville Hospital System University Medical Center †Department of Biology, Furman University §Cancer Centers of the Carolinas, Greenville, SC.
Am J Clin Oncol. 2014 Aug;37(4):364-8. doi: 10.1097/COC.0b013e31827b459a.
To assess clinical features that may predispose individuals taking gemcitabine to new-onset congestive heart failure.
A retrospective chart review was conducted with 156 female patients, 51 with ovarian cancer and 105 with breast, lung, pancreas, and bladder cancer, all of whom had received gemcitabine. Patients with new-onset congestive heart failure were compared with patients without new-onset congestive heart failure with the use of Wilcoxon rank-sum test for continuously distributed data and the Fisher exact test for proportions.
Seven patients developed new-onset congestive heart failure (4.5%) during their treatment, which was significantly greater than that reported previously (0.76%). Patients with new-onset congestive heart failure did not differ from other patients in the study for age, weight, gravidity, parity, body mass index, and type of cancer. They also did not differ in history of myocardial infarction, hypertension, prior episodes of congestive heart failure, prior treatment with adriamycin, or use of tobacco. However, diabetes mellitus and coronary artery disease were more common, and all patients who developed new-onset congestive heart failure received >17,000 mg/m of gemcitabine. The incidence of new-onset congestive heart failure in this study is significantly higher than previously reported with the use of gemcitabine.
The single-most predictive risk factor for new-onset congestive heart failure in this cohort of patients is the receipt of a minimum dose of 17,000 mg/m. Therefore, additional follow-up may be necessary for all patients receiving >15,000 mg/m of gemcitabine to screen for potential new-onset congestive heart failure.
评估可能导致接受吉西他滨治疗的个体新发充血性心力衰竭的临床特征。
对 156 名女性患者（51 例卵巢癌患者和 105 例乳腺癌、肺癌、胰腺癌和膀胱癌患者）进行了回顾性图表审查，所有患者均接受了吉西他滨治疗。使用 Wilcoxon 秩和检验比较新发充血性心力衰竭患者和无新发充血性心力衰竭患者的连续分布数据，使用 Fisher 确切检验比较比例。
7 名患者（4.5%）在治疗期间出现新发充血性心力衰竭，明显高于先前报告的（0.76%）。新发充血性心力衰竭患者与研究中的其他患者在年龄、体重、孕次、产次、体重指数和癌症类型方面无差异。他们在心肌梗死、高血压、充血性心力衰竭既往发作、阿霉素既往治疗或吸烟史方面也无差异。然而，糖尿病和冠状动脉疾病更为常见，所有新发充血性心力衰竭患者均接受了>17,000mg/m 的吉西他滨。与先前使用吉西他滨的报道相比，本研究中新发充血性心力衰竭的发生率明显更高。
在本队列患者中，新发充血性心力衰竭的唯一最具预测性风险因素是接受了至少 17,000mg/m 的剂量。因此，对于所有接受>15,000mg/m 的吉西他滨的患者，可能需要进行额外的随访以筛查潜在的新发充血性心力衰竭。
