A retrospective study of cardiotoxicity of breast cancer patients treated with doxorubicin at Phrachomklao Hospital

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Lersak Prachuabaree
Sawitree Ket-aim


Doxorubicin is chemotherapeutic agent in the standard regimen for the treatment of breast cancer. The major adverse drug reaction is cardiotoxicity. This study aimed to determine the incidence and risk-factors of congestive heart failure (CHF) in breast cancer patients treated with doxorubicin at Phrachomklao Hospital. Methods: This was a 10-year retrospective study of breast cancer patients treated with doxorubicin at Phrachomklao Hospital from January 1, 2008 to December 31, 2018. The data was collected from electronic medical records (EMR). A logistic regression analysis was used to determine factors associated with the development of CHF. Result: Two hundred thirteen patients were prescribed 574 doses of doxorubicin. The incidence of doxorubicin-induced congestive heart failure was 5.6% (12 cases, 0.0209 events per patient-dose of exposure), seven patients (3.29%) developed early-onset congestive heart failure and 5 patients (2.33%) developed late-onset congestive heart failure. The only significant risk factor for CHF was cumulative dose of doxorubicin. A cumulative dose over 300 mg/mm2 showed higher incidence of CHF compared to lower cumulative dose (< 300 mg/m2) (RR 4.48, 95% CI; 1.30-15.45, p= 0.01). The risk of CHF in patients undergoing hormone therapy was lower. Conclusion: The incidence of doxorubicin-induced CHF in breast cancer patients treated with doxorubicin at Phrachomklao Hospital was 5.6% within the first year. A cumulative dose greater than 300 mg/mm2 was a significant risk factor for developing heart failure. Close monitoring of cardiotoxicity should be performed in high risk patients, especially during the first year post treatment.


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