J Korean Med Sci.  2010 Sep;25(9):1336-1342. 10.3346/jkms.2010.25.9.1336.

Dexrazoxane for Preventing Anthracycline Cardiotoxicity in Children with Solid Tumors

• Choi HS
• Park ES
• Kang HJ
• Shin HY
• Noh CI
• Yun YS
• Ahn HS
• Choi JY

• KMID: 1785914
• DOI: http://doi.org/10.3346/jkms.2010.25.9.1336

Abstract

This study attempted to assess the incidence and outcome of anthracycline cardiotoxicity and the role of dexrazoxane as a cardioprotectant in childhood solid tumors. The dexrazoxane group included 47 patients and the control group of historical cohort included 42. Dexrazoxane was given in the 10:1 ratio to doxorubicin. Fractional shortening and systolic and diastolic left ventricular diameters were used to assess the cardiac function. The median follow-ups were 54 months in the dexrazoxane group and 86 months in the control group. The mean cumulative doses of doxorubicin were 280.8+/-83.4 mg/m2 in the dexrazoxane group and 266.1+/-75.0 mg/m2 in the control group. The dexrazoxane group experienced significantly fewer cardiac events (27.7% vs. 52.4%) and less severe congestive heart failure (6.4% vs. 14.3%) than the control group. Thirteen cardiotoxicities including one cardiac death and 2 congestive heart failures occurred in the dexrazoxane group, and 22 cardiotoxicities including 2 cardiac deaths and 4 congestive heart failures, in the control group. Five year cardiac event free survival rates were 69.2% in the dexrazoxane group and 45.8% in the control group (P=0.04). Dexrazoxane reduces the incidence and severity of early and late anthracycline cardiotoxicity in childhood solid tumors.

Keyword

Dexrazoxane; Doxorubicin; Cardiotoxicity; Child; Solid Tumors

MeSH Terms

Adolescent
Antibiotics, Antineoplastic/*adverse effects
Cardiomyopathies/chemically induced/prevention & control
Cardiovascular Agents/*therapeutic use
Child
Child, Preschool
Cohort Studies
Disease-Free Survival
Doxorubicin/*adverse effects
Echocardiography
Female
Follow-Up Studies
Heart Failure/chemically induced/prevention & control
Humans
Infant
Male
Neoplasms/*drug therapy/mortality
Razoxane/*therapeutic use
Ventricular Function, Left/physiology

Figure

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  Fig. 1 Kaplan-Meier analysis of cardiac event free survival.

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