Kuroda Junko, Oikawa Masayoshi, Tokuda Emi, Tachibana Kazunoshin, Sasaki Eisaku, Ohtake Tohru, Takeishi Yasuchika, Saji Shigehira
Department of Pharmacy, Fukushima Medical University Hospital, 1 Hikarigaoka, Fukushima, 960‑1295, Japan.
Department of Cardiovascular Medicine, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960‑1295, Japan.
Support Care Cancer. 2024 Dec 9;33(1):8. doi: 10.1007/s00520-024-09067-0.
Cardiac dysfunction as a result of anthracycline treatment is a major concern regarding the management of patient life after therapy. The aim of the present study was to determine the clinical characteristics of cancer patients at high risk of developing cancer therapy-related cardiac dysfunction (CTRCD), in order to improve the risk management for the appropriate treatment.
This is a single-center, retrospective study of patients with breast cancer who underwent anthracycline treatment and had regular consultations with cardiologists. To investigate the incidence of CTRCD and the risk factors related to its occurrence, left ventricular ejection fraction (LVEF), cardiac troponin I (TnI), and brain natriuretic peptide (BNP) were assessed in 177 patients at the start of anthracycline treatment, and again at 3, 6, 9, and 12 months.
Eight patients (4.5%) developed CTRCD (CTRCD group). The comparisons between the CTRCD group and those without CTRCD (non-CTRCD group) showed significant differences in pre-treatment cancer stage and neutrophil/lymphocyte ratio (NLR). Multivariate analysis showed a strong association between pre-treatment cancer stage, NLR, and type of anthracycline administered (epirubicin or doxorubicin).
High NLR, the more advanced stages of cancer, and doxorubicin administration were suggested as possible risk factors for the development of CTRCD. Special attention should be warranted for patients with any of these risk factors.
蒽环类药物治疗导致的心脏功能障碍是治疗后患者生活管理的主要关注点。本研究的目的是确定有发生癌症治疗相关心脏功能障碍（CTRCD）高风险的癌症患者的临床特征，以改善适当治疗的风险管理。
这是一项对接受蒽环类药物治疗并定期咨询心脏病专家的乳腺癌患者的单中心回顾性研究。为了调查CTRCD的发生率及其发生相关的危险因素，在177例患者蒽环类药物治疗开始时以及3、6、9和12个月时评估左心室射血分数（LVEF）、心肌肌钙蛋白I（TnI）和脑钠肽（BNP）。
8例患者（4.5%）发生CTRCD（CTRCD组）。CTRCD组与未发生CTRCD的患者（非CTRCD组）之间的比较显示，治疗前癌症分期和中性粒细胞/淋巴细胞比值（NLR）存在显著差异。多因素分析显示，治疗前癌症分期、NLR与蒽环类药物类型（表柔比星或多柔比星）之间存在密切关联。
高NLR、癌症晚期和多柔比星给药被认为是CTRCD发生的可能危险因素。对于有这些危险因素之一的患者应给予特别关注。
