| Objective: In this study,the probability and time distribution of anthracyclines(E group),docetaxel combined with carboplatin/cisplatin,trastuzumab chemotherapy(H group),and proto-trastuzumab chemotherapy(E+H group)on drug-induced cardiotoxic events were analyzed and compared.In addition,markers(namely c Tn I and nt-probnp)were compared to predict the clinical value of drug-induced cardiac dysfunction in the chemotherapy group of E+H patients,and early intervention was conducted to provide clinical experience for the subsequent tumor chemotherapy to lead to cardiac toxicity and reduce the probability of cardiovascular events in patients after chemotherapy.Methods: This study retrospectively collected 121 patients who were admitted to the department of oncology of the people's hospital of Inner Mongolia autonomous region from September 2016 to September 2019 and were confirmed to be HER2 positive by histopathology and immunohistochemistry and had undergone breast cancer surgery.The basic clinical characteristics of the patients were analyzed retrospectively,and the serum concentrations of heart rate,cardiac ejection fraction(LVEF),markers c Tn I and nt-probnp were recorded.Three groups of patients were observed for 15 months after treatment,with cardiotoxicity as the screening node.The three groups of patients were divided into cardiotoxicity group and non-cardiotoxicity group until the observation node,and the grouping was based on the diagnostic basis of drug-induced cardiotoxicity.The study compared the time and probability of cardiotoxic events between three groups of different treatment schemes and the difference between the non-cardiotoxic group,and discussed the comparison in the E+H group c Tn I,nt-probnp early monitoring of cardiac dysfunction caused by drugs,P<0.05 is statistically significant difference.Results:(1)the baseline level of the patients was collected for analysis and it was found that the three groups had P>0.05 in age,height and body mass index(BMI),and the difference was not statistically significant.There was no significant difference in heart rate,ejection fraction,c Tn I,nt-probnp among the three groups before treatment(P>0.05).The basis of other clinical data is as strong as ever with three highs or high blood pressure(> 1 year),hyperlipidemia,diabetes,and other genetic diseases,such as family history of heart disease,thyroid metabolic disease,smoking,and the mode of operation,tumor stage,ER,PR positive or not,positive or not Ki-67% value,the presence of endocrine therapy and clinical indicators by chi-square analysis found that P > 0.05,for there was no statistically significant difference;(2)in the three groups of patients in drug on the incidence of cardiac toxicity,through chi-square: cardiac toxicity events group E the probability of the highest(39.02%),followed by E + H group(22.22%),H(14.29%),by chi-square analysis found that three groups of different sex incidence of cardiac toxicity in drug treatment is 0.039,think of three groups of patients the incidence of cardiac function obstacle was statistically significant,the three groups of patients with different treatments of different lead to the prevalence of heart;The analysis and comparison of cardiotoxicity of the three groups by 2-slice method was found to be statistically insignificant(P>0.01).This indicated that the incidence of cardiac toxicity in group E did not increase in patients who had followed the administration of ritutrastuzumab and had ANTs before the administration of trastuzumab.(3)according to the time distribution of cardiac toxicity,statistical analysis showed that the incidence of chronic cardiac toxicity in the three groups was the highest,respectively:E group is 68.8%,H group is 80.0% and E+H group is 100%.(4)in the E + H group in patients with cardiac function index forecast,to observe whether the node of heart can be divided into cardiac toxicity and non cardiac toxicity group referring to the diagnosis of drug-induced cardiac toxicity,chi-square analysis and comparison of E + H after dosing schedule cardiac toxicity(N = 10)and the cardiac toxicity(N = 35),the study found that in the time period of T1 ~ T15,c Tn Ionwhether there is difference in the incidenceofcardiactoxicitybetweensignificance(P<0.05),atthesametimefound that the NT-pro BNP in both analysis of no statistical significance(P > 0.05),It can be seen that the blood concentrati,on level of c Tn I has great predictive value in clinical practice.(5)in the Logistic regression analysis study of single factor in E+H group,smoking(with vs.None(P = 0.006),hypertension(with vs.None(P = 0.033),hyperlipidemia(with vs.No)(P =0.033)and c Tnl(P =0.028)were the possible influencing factors of cardiac toxicity in patients treated with E+H regimen,and Logistic multivariate analysis found that only c Tnl(P = 0.037)could be used as independent predictors of E+H regimen for breast cancer patients.Conclusions:(1)compared with other chemotherapy drugs,ANTs chemotherapy is prone to cardiac toxicity.(2)after administration of ANTs,chemotherapy with ritutrastuzumab did not increase the incidence of drug-induced cardiotoxic events.(3)the majority of drug-induced cardiotoxicity events(80.66%)occurred chronic cardiotoxicity,that is,within 1 month to 1 year after chemotherapy;(4)the study found that c Tn I could predict the occurrence of drug-induced cardiotoxicity in the early stage,and only c Tnl(P = 0.037)was an independent predictor of her-2 positive breast cancer patients treated with the E+Hregimen. |
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