Cemil BİLİR, Hüseyin ENGİN, Turgut KARABAG, Derya DEMİRTAS, Orhan DEMİRTAS

Early Effects of Breast Cancer Chemotherapy by Fluorouracil, Epirubicin and Cyclophosphamide with or without Docetaxel Regimen on the Right and Left Ventricle Functions

Amaç: Meme kanseri tedavisi Fluorouracil, Epirubicin and Cyclophosphamide (FEC) VEFEC-Docetaxel ile yapılan anjuvanprotokolü sırasında global kardiyak fonksiyon durumunun incelenmesi.Gereç ve Yöntem: Onkoloji bölümünde meme kanseri nedeniyle adjuvant tedavi gören 51 hasta çalışmaya alındı.Bulgular: Tedavi başlangıcı ile karşılaştırıldığında 6 aylık tedavi sonrası LVEF 66%±3 den 64.5%±4.4 e düştü, p=0.001. 6aylık takipte Sol Ventriküler MPI değerleri bazal değerler olan 0.45±0.1 dan 0.58±0.15 e yükseldi, p=0.0001. Tedavi öncesive sonrası ortalama TAPSE değerleri sırasıyla 2.45±0.42 ve 2.05±0.35 cm, p=0.0001 idi. Altı aylık tedavi sonrasında, bazalölçümlerler kıyaslandığında Sağ Ventriküler TDI MPI değerlerinde tedavi sonrası anlamlı artış saptandı (0.23 ve 0.37,p=0.0001). Yalnızca FEC ve Docetaxel fonrası FEC rejimlerine ait tedavi öncesi ve sonrası LVEF, LV MPI, TAPSE ve RV TDIMPI ölçümlerinin Delta değerleri karşılaştırıldığında, anlamlı bir değişiklik saptanmadı (sırasıyla p= 0.08, p=0.38, p=0.43and p=0.2).Sonuç: TAPSE, LVD TDI MPI ve RD TDI MPI ile değerlendirildiğinde, FEC kemoterapisi subklinik Sağ Ventriküldisfonksiyonuyla ilişkilidir.

Anahtar Kelimeler:

Kemoterapi, FEC-Docetaxel rejimi, Ekokardiografi, TAPSE, tei index

Early Effects of Breast Cancer Chemotherapy by Fluorouracil, Epirubicin and Cyclophosphamide with or without Docetaxel Regimen on the Right and Left Ventricle Functions

Objectives: to investigate global cardiac functional status during adjuvant chemotherapy with Fluorouracil, Epirubicin andCyclophosphamide (FEC) and FEC-Docetaxel protocol for breast cancer.Material and Method: 51 women treated with adjuvant chemotherapy for breast cancer at the oncology department.Results: LVEF decreased from baseline values of 66%±3 to 64.5%±4.4, p=0.001 at six month calculations as compared tothe beginning. There was increase in the Left Ventricular MPI values from the baseline records of 0.45±0.1 to 0.58±0.15,p=0.0001 at six months follow-up. Mean TAPSE values were 2.45±0.42 and 2.05±0.35 cm respectively, p=0.0001. Therewas increase in the right ventricular TDI MPI values after the therapy as compared to the baseline calculations (0.23 and0.37, p=0.0001) at six months. When we compare the delta values of LEVF, LV MPI, TAPSE and RV TDI MPI in groupof FEC alone and FEC followed by Docetaxel regimen, we did not fi nd any signifi cant changes before and after thechemotherapy (p= 0.08, p=0.38, p=0.43 and p=0.2, respectively).Conclusion: Chemotherapy with FEC is associated with subclinical right and left ventricular dysfunction as assessedby TAPSE, left ventricular Doppler myocardial performance index, and right ventricular tissue Doppler myocardialperformance index.

Keywords:

Chemotherapy, FEC-Docetaxel regimen, Echocardiography, TAPSE, tei index,

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