Several antineoplastic drags have been reported to cause cardiac side effects including cardiomyopathy, ischemias, arrhitmias and myocardial necrosis and cardiotoxicity is an important chronic cumulative dose-limiting toxicity of many therapeutic antineoplastic regimen. We analysed cardiac funcion in 13 advanced breast cancer patients, 6 treated whit 6 cycles of FEC (5-fluorouracil 600 mg/m2; epirubicin 90 mg/m2; cyclophosphamide 600 mg/m2) and 7 treated with 6 cycles of AFEC (FEC plus amifostine 740 mg/m2). Amifostme is an organic thiophosphate derivative that selectively protects normal tissues from treatment-related toxicity without any demonstrated diminution of antitumor efficacy. Our patients were monitored, before (I) and after (II) chemotherapy, by clinical evaluation, ECG, EcoCG, miocardial scintigraphy (SPECT) and endomiocardial biopsy (EMCB) in the same ventricular region evaluated by SPECT. Cardiac monitoring in both groups did not reveal significant changes in clinical, ECG, EcoCG and scintigraphic parameters while after treatment, we found, in patients who had received FEC, a cytoskeleton damage with a loss of contractile filaments (Actin 93 3% vs 65%) and an increase of fibrosis (Vimentin 43.3% vs 60%), initial markers of irreversible myocardial impairment. No alterations were found in patients receiving AFEC before and aftertreatment (Actin 91 4% vs 86%, Vimentin 28 6% vs 25%).
Preliminary analysis of chemotherapy-induced cardiotoxicity in breast cancer patients treated with amifostine / Marinelli, A; Romano, C; DI SOMMA, Salvatore. - In: ANNALS OF ONCOLOGY. - ISSN 0923-7534. - STAMPA. - 11 SI:4:(2000), pp. 141-142.