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保护早期乳腺癌患者免受蒽环类药物诱导的心脏毒性。

Protects Against Anthracycline-Induced Cardiotoxicity in Early Breast Cancer Patients.

机构信息

Long Hua Hospital, Shanghai, China.

出版信息

Integr Cancer Ther. 2020 Jan-Dec;19:1534735420945017. doi: 10.1177/1534735420945017.

Abstract

Anthracycline-based chemotherapy is an effective treatment used for early-stage breast cancer patients. However, anthracycline use is limited due to its cardiotoxic effects. Recent studies have shown that (PG) protects the heart from anthracycline-induced cardiotoxicity. However, no randomized, placebo-controlled clinical trial has been performed to investigate the clinical use of PG to prevent anthracycline-induced cardiotoxicity. This study aimed to evaluate the cardioprotective effects and safety of PG in early breast cancer patients receiving anthracycline-based chemotherapy. A total of 125 early breast cancer patients receiving anthracycline-based chemotherapy were enrolled and randomized into a PG group or placebo group in a 1:1 ratio. Only 2 (3.1%) participants in the placebo group and 1 (1.6%) participant in the PG group experienced NYHA (New York Heart Association) class III or IV heart failure. There were no significant differences observed between the 2 groups. However, compared with the placebo group, patients in the PG group showed a lower incidence of subclinical heart failure (21.9% vs 8.2%, respectively, = .033), as well as lower cardiac troponin T levels (48.4% vs 31.1%, respectively, = .002). Importantly, there were no differences observed in the antitumor effects of anthracycline between the 2 groups (disease-free survival: hazards ratio = 1.09, 95% confidence interval = 0.45-2.62, = .84; overall survival: hazards ratio = 1.46, 95% confidence interval = 0.33-6.43, = .62). PG prevents anthracycline-induced acute and chronic cardiac injury in early-stage breast cancer patients without compromising the antitumor effects of chemotherapy.

摘要

蒽环类化疗是早期乳腺癌患者的有效治疗方法。然而,由于其心脏毒性,蒽环类药物的使用受到限制。最近的研究表明,(PG)可保护心脏免受蒽环类药物引起的心脏毒性。然而,尚未进行随机、安慰剂对照的临床试验来研究 PG 在预防蒽环类药物引起的心脏毒性中的临床应用。本研究旨在评估 PG 在接受蒽环类化疗的早期乳腺癌患者中的心脏保护作用和安全性。

共纳入 125 例接受蒽环类化疗的早期乳腺癌患者,按 1:1 比例随机分为 PG 组或安慰剂组。安慰剂组仅 2 例(3.1%)和 PG 组 1 例(1.6%)患者出现纽约心脏协会(NYHA)Ⅲ或Ⅳ级心力衰竭。两组间无显著差异。然而,与安慰剂组相比,PG 组患者亚临床心力衰竭的发生率较低(分别为 21.9%和 8.2%, =.033),心脏肌钙蛋白 T 水平也较低(分别为 48.4%和 31.1%, =.002)。重要的是,两组间蒽环类药物的抗肿瘤作用无差异(无病生存:风险比=1.09,95%置信区间=0.45-2.62, =.84;总生存:风险比=1.46,95%置信区间=0.33-6.43, =.62)。

PG 可预防早期乳腺癌患者蒽环类药物引起的急性和慢性心脏损伤,而不影响化疗的抗肿瘤作用。

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