CARDIOTOXICITY RISK PREDICTION IN BREAST CANCER PATIENTS
- PMID: 34965569
- DOI: 10.33145/2304-8336-2021-26-498-512
CARDIOTOXICITY RISK PREDICTION IN BREAST CANCER PATIENTS
Abstract
Breast cancer patients receive combined antitumor treatment (surgery, chemotherapy, targeted drugs and radia-tion), so they are considered to be the patients with potentially high risk of cardiotoxicity (CT). Risk stratificationof cardiovascular complications before the beginning and during the cancer treatment is an important issue.
Objective: to develop a CT risk model score taking into account cardiological, oncological and individual risks.
Material and methods: The study included 52 breast cancer patients with retrospective analysis of their medicalhistory, risk factors, and echocardiographic parameters before the onset and in 12 months follow up. Based on theanalysis of the data, a CT risk model score was developed and recommended. The patients were divided into groupsaccording to the score: Group 1 - low risk of CT development - score < 4 points, Group 2 - moderate risk - 5-7points, Group 3 - high risk > 8 points. According to the scale, BC patients with a total of > 8 points are consideredto be at high risk for CT complications. Radiation therapy and anthracyclines, as well as associated cardiovasculardiseases were the most important risk factors of CT.
Results: Based on the study of retrospective analysis of risk factors, data of heart function monitoring during follow-up,the risk model score of cardiotoxicity has been developed for the BC patients' stratification. According to the proposedscore risk model, BC patients with a total score of > 8 points considered to have high risk of cardiotoxic complications.
Conclusions: Using of the proposed risk model score with calculation of CT risk factors both before the beginningand during cancer therapy is important, because it allows predicting the risk of CT development - to identify high-risk patients, accordingly, to develop an individualized plan for cardiac function monitoring and to start timely cardioprotective therapy.
Khvori na RGZ otrymuiut' kombinovane protypukhlynne likuvannia (khirurgichne likuvannia, khimiieterapiiu, targetnuta promenevu terapiiu), tomu ie patsiientamy potentsiĭno vysokogo ryzyku kardiovaskuliarnoï toksychnosti (KT).Stratyfikatsiia ryzyku sertsevo-sudynnykh uskladnen' do pochatku ta v protsesi protypukhlynnogo likuvannia ievazhlyvym pytanniam.Meta roboty: rozroblennia shkaly ryzyku rozvytku KT z urakhuvanniam kardiologichnogo, onkologichnogo taindyvidual'nogo ryzykiv. Material i metody. V doslidzhennia vkliucheno 52 khvorykh na rak grudnoï zalozy, v iakykh provedeno retrospek-tyvnyĭ analiz anamnezu, faktoriv ryzyku, ekhokardiografichnykh pokaznykiv do pochatku likuvannia ta cherez 12misiatsiv. Na osnovi analizu danykh bula rozroblena i zaproponovana shkala ryzyku KT. Patsiienty buly roz-podileni na grupy za sumoiu baliv: 1-sha grupa – z nyz'kym ryzykom rozvytku KT – suma baliv < 4 baly; 2-gagrupa – pomirnyĭ ryzyk – 5–7 baliv; 3-tia grupa – vysokyĭ ryzyk > 8 baliv. Zgidno z rozroblenoiu shkaloiukhvori na rak grudnoï zalozy, iaki maiut' v sumi > 8 baliv, ie patsiientamy vysokogo ryzyku KT uskladnen'. Naĭva-gomishymy faktoramy ryzyku KT buly promeneva terapiia ta likuvannia antratsyklinamy, a takozh suputni sertse-vo-sudynni zakhvoriuvannia.Rezul'taty. Na osnovi vyvchennia danykh retrospektyvnogo analizu FR kardiotoksychnosti, zistavlennia ïkh z da-ny my EkhoKG v dynamichnomu sposterezhenni rozrobleno shkalu ryzyku rozvytku kardiotoksychnosti z metoiustratyfikatsiï khvorykh na RGZ. Zgidno z rozroblenoiu shkaloiu khvori na RGZ, iaki maiut' v sumi > 8 baliv ie patsiienta-my vysokogo ryzyku KT uskladnen'.Vysnovky. Vykorystannia zaproponovanoï shkaly ryzyku z urakhuvanniam i obchyslenniam faktoriv ryzyku KT iakdo pochatku, tak i v protsesi protypukhlynnoï terapiï ie vazhlyvym, oskil'ky dozvoliaie prognozuvaty ryzyk roz-vytku KT – vydiliaty khvorykh vysokogo ryzyku, vidpovidno rozrobliaty indyvidual'nyĭ plan monitoryngufunktsiï sertsia z metoiu vchasnogo pryznachennia ïm kardioprotektyvnoï terapiï.
Keywords: breast cancer; cardiotoxicity; heart failure; prognosis; risk scale.
S. M. Kozhukhov, N. V. Dovganych, I. I. Smolanka, O. F. Lygyrda, О. Ye. Bazyka, S. A. Lyalkin, O. M. Ivankova, O. A. Yarinkina, N. V. Tkhor.