Keywords
Breast Neoplasms
Cardiomyopathies
How to Cite
Abstract
Anthracyclines are chemotherapeutic agents that were considered the cornerstone for multiple chemotherapy regimes. Despite being an encouraging treatment, it faces several side-effects, some of the more prominent are heart condition characterized by arrhythmogenic, cardiac ischemic events, cardiomyopathy and cardiac failure; these side-effects diminish the patient´s quality of life and in more severe cases it can lead to fatal cardiotoxicity. The objective of the present article is to emphasize on the possible side-effects that oncologic patients may present when using anthracyclines as oncologic agents. For that purpose the descriptions of two patients with breast cancer are presented, where the side effect presented is cardiotoxicity secondary to the use of anthracyclines; such cases stress the need for acomplete, integral and multidisciplinary management. In addition to this, literature was revised making emphasis on pathophysiological mechanisms, clinical presentation, early detection, and the therapy for the side-effect previously mentioned. (MÉD.UIS. 2012;25(3):265-72).
References
2. Gianni L, Herman E, Lipshultz S, Minotti G, Sarvazyan N, Sawyer D. Anthracycline Cardiotoxicity: From Bench to Bedside. J Clin Oncol. 2008;26:3777-84.
3. Singal PK, Iliskovic N. Doxorubicin-induced cardiomyopathy. N Engl J Med. 1998;339(13):900-5.
4. Cardinale D, Colombo A, Sandri MT, Lamantia G, Colombo N, Civelli M, et al. Prevention of High-Dose Chemotherapy–Induced Cardiotoxicity in High-Risk Patients by Angiotensin-Converting Enzyme Inhibition. Circulation. 2006;114:2474-81.
5. Globocan 2008. Cancer Incidence and Mortality Worldwide in 2008. Disponible en: http://globocan.iarc.fr/factsheets/cancers/breast.asp.
6. Doyle JJ, Neugut AI, Jacobson JS, Grann VR, Hershman DL. Chemotherapy and Cardiotoxicity in Older Breast Cancer Patients: A Population-Based Study. J Clin Oncol. 2005;23(34):8597-605.
7. Crivellari D, Bonetti M, Castiglione-Gertsch M, Gelber RD, Rudenstam CM, Thürlimann B, et al. Burdens and benefits of adjuvant cyclophosphamide, methotrexate, and fluorouracil and tamoxifen for elderly patients with breast cancer: The International Breast Cancer Study Group Trial VII. J Clin Oncol. 2000;18(7):1412-22.
8. Kalay N, Basar E, Ozdogru I, Ozlem E, Cetinkaya Y, Dogan A, et al. Protective Effects of Carvedilol Against Anthracycline-Induced Cardiomyopathy. J Am Coll Cardiol. 2006;48(11):2259-64.
9. Barrett-Lee P, Dixon JM, Farrell C, Jones A, Leonard R, Murray N, et al. Expert opinion on the use of anthracyclines in patients with advanced breast cancer at cardiac risk. Ann Oncol. 2009;20(5):816-27.
10. Vergely C, Delemasure S, Cottin Y, Rochette L. Preventing the cardiotoxic effects of anthracyclines: from basic concepts to clinical data. Heart Metab. 2007;35:1-7.
11. Van-Dalen EC, Michiels EM, Caron HN, Kremer LC. Different anthracycline derivates for reducing cardiotoxicity in cancer patients. Cochrane Database Syst Rev. 2006;4:CD005006.
12. Zucchi R, Danesi R. Cardiac toxicity of antineoplastic anthracyclines. Curr Med Chem. 2004;3:151-71.
13. Maradia K, Guglin M. Pharmacologic Prevention of Anthracycline- Induced Cardiomyopathy. Cardiology. 2009; 17(5):243-52.
14. Pai VB, Nahata MC. Cardiotoxicity of chemotherapeutic agents: incidence, treatment and prevention. Drug Saf. 2000;22:263-302.
15. Nakamae H, Tsumura K, Terada Y, Nakane T, Nakamae M, Ohta K, et al. Notable Effects of Angiotensin II Receptor Blocker, Valsartan, on Acute Cardiotoxic Changes after Standard Chemotherapy with Cyclophosphamide, Doxorubicin, Vincristine, and Prednisolone. Cancer. 2005;104:2492-8.
16. Pinder MC, Duan Z, Goodwin JS, Hortobagyi GN, Giordano SH. Congestive heart failure in older women treated with adjuvant anthracycline chemotherapy for breast cancer. J Clin Oncol. 2007;25(25):3808-15