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자료유형
학술저널
저자정보
김인호 (가톨릭대학교) 이지은 (가톨릭대학교) 윤호중 (가톨릭대학교) 송병주 (가톨릭대학교) 채병주 (가톨릭대학교)
저널정보
한국유방암학회 Journal of Breast Cancer Journal of Breast Cancer Vol.20 No.1
발행연도
2017.1
수록면
82 - 90 (9page)

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Purpose: We intended to determine whether dexrazoxane (DZR) is cardioprotective during administration of adjuvant anthracycline- based chemotherapy followed by a 1-year trastuzumab treatment. Methods: The medical records of 228 patients who underwent surgical resection and received adjuvant chemotherapy with trastuzumab for human epidermal growth factor receptor type 2 (HER2)-positive breast cancer between January 2010 and December 2014 were reviewed. Approximately 25% of patients received DZR prior to each administration of doxorubicin during doxorubicin with cyclophosphamide (AC) chemotherapy. DZR was not administered during the 1-year trastuzumab maintenance period. Rates of cardiac events (reduction in left ventricular ejection fraction [LVEF] by 10% or more; reduction in absolute LVEF to <45%) and cardiac event-free duration (CFD) were examined. The trastuzumab interruption rate was also assessed. Results: Twelve percent of patients experienced a cardiac event. Repeated-measures analysis of variance for ejection fraction revealed a significant main effect of time, and a significant group (DZR)×time interaction. The group treated with adjuvant chemotherapy and DZR experienced significantly lower frequencies of cardiac events than the adjuvant chemotherapy only group. In multivariate analysis, DZR administration was associated with significantly fewer cardiac events. Moreover, DZR administration was an independent good prognostic factor for CFD. Only one patient (2.3%) experienced early interruption of trastuzumab in the adjuvant chemotherapy with DZR group due to cardiac toxicity, whereas 10 patients (7.6%) experienced a trastuzumab stop event in the adjuvant chemotherapy only group. Conclusion: DZR is cardioprotective in HER2-positive breast cancer patients who received adjuvant chemotherapy with trastuzumab. A large cohort randomized trial is needed to determine if DZR has an effect on trastuzumab interruption and completion of 12-month trastuzumab. Because cardiac toxicity has a significant negative effect on trastuzumab maintenance and quality of life, DZR administration could be considered concomitantly with anthracycline- based adjuvant chemotherapy with trastuzumab.

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참고문헌 (25)

참고문헌 신청
Slamon DJ / 1987 / Human breast cancer: correlation of relapse and survival with amplification of the HER-2/neu oncogene / Science 235:177~182 google schola Romond EH / 2005 / Trastuzumab plus adjuvant chemotherapy for operable HER2-positive breast cancer / N Engl J Med 353:1673~1684 google schola Perez EA / 2014 / Trastuzumab plus adjuvant chemotherapy for human epidermal growth factor receptor 2-positive breast cancer: planned joint analysis of overall survival from NSABP B-31 and NCCTG N9831 / J Clin Oncol 32:3744~3752 google schola Ayres LR / 2015 / Trastuzumab induced cardiotoxicity in HER2 positive breast cancer patients attended in a tertiary hospital / Int J Clin Pharm 37:365~372 google schola Jian Xue / 2014 / Risk of Trastuzumab-Related Cardiotoxicity in Early Breast Cancer Patients: A Prospective Observational Study / Journal of Breast Cancer 17(4):363~369 dbpia

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