XXII Congresso Brasileiro de Oncologia Clínica

Dados do Trabalho


Título

CHEMOTHERAPY-INDUCED CARDIOTOXICITY IN PATIENTS WITH BREAST CANCER: IDENTIFIYING HIGH RISK PATIENTS

Introdução

Despite the undeniable prognostic benefit of chemotherapy agents, the
risk of developing cardiotoxicity for patients undergoing oncologic therapy is rapidly
increasing. Added to this, there is paucity of information on Brazilian medical literature
regarding this subject, which can impair the appropriate management of these
patients.

Objetivo

This study aimed to identify patients with breast cancer submitted to
chemotherapy who are considered as high risk for cardiotoxicity.

Método

Observational cross-sectional single-center study that included female
patients with breast cancer, 18 years old or above, who underwent chemotherapy
protocol using doxorrubicin and/or cyclophosphamide between July 2018 and July
2021. Age of 65 or above, two or more clinical cardiovascular risk factors and high
cumulative dose of antineoplastic agents were considered as risk factors associated
with cardiotoxicity.

Resultado

We included 146 patients, with a mean age of 51.5 years, from which 66
(42,4%) were considered as high risk for cardiotoxicity. Twenty-two patients (15.1%)
had two or more clinical risk factors, 26 (17.8%) were 65 years old or above, and 33
(22.6%) had a cumulative dose of doxorrubicin ≥ 250mg. The prevalence of
hypertension was 46.6%, diabetes 21.9%, current smoking 8.2%, and dyslipidemia
8.9%. One patient (0.7%) had chronic kidney disease, and one (0.7%) had previous
myocardial infarction. Doxorrubicin was used in 124 patients (84.9%),
cyclophosphamide in 132 (90.4%), and trastuzumab in 14 (9.4%). Mean left ventricle
ejection fraction was 68% before and 62% after chemotherapy. Seven patients (4.8%)
presented heart failure in an average follow-up of 6 months.

Conclusão

Approximately one in every seven patients with breast cancer submitted
to chemotherapy was considered as high risk for chemotherapy-induced cardiotoxicity.
Despite its efficacy against cancer, anthracyclines and other potential cardiotoxic
agents can lead to cardiac injury and heart failure. Although the risk is dose-
dependent, no dose is totally safe in high risk patients. A thorough follow-up is strongly
recommended for such patients, and integration between Oncology and Cardiology is
essential for preventing cardiotoxicity.

Palavras-chave

Antineoplastic Agents; Breast Cancer; Cardiotoxicity.

Área

Oncologia - Prevenção, rastreamento e diagnóstico

Autores

LARISSA VITTORACI BERNARDINI, LUIZA HANDERE LORENCINI, YASMIM BATISTA OLIVEIRA, ROBERTO RAMOS BARBOSA, LUANA TAMARA PESCUITE