Resumen de Efects of Doxorubicin, Epirubicin, and Liposomal Doxorubicin (Anthracycline) on cardiac function in patients with osteosarcoma and their infuencing factors
Shanshan Ding, Shasha Xiong, Xueli Wang, Changdong Zhang, Song Chen, Ming Sun, Chunlin Wu, Xing Zhang, Meiying Wang, Jia Wang Ding, Xiaoke Shang
Objective The objective of this study was to investigate the impact of Doxorubicin, Epirubicin, and Liposomal Doxorubicin (Anthracycline) on cardiac function in osteosarcoma patients and analyze the factors infuencing this efect.
Methods A retrospective study was conducted on 165 osteosarcoma patients admitted to our hospital from January 2020 to December 2022. Based on the chemotherapy regimen, the patients were divided into two groups: the control group (n=62) treated with Cisplatin and cyclophosphamide, and the observation group (n=103) treated with Doxorubicin, Epirubicin, and Liposomal Doxorubicin (Anthracycline). The general records of both groups were analyzed, and left ventricular ejection fraction (LVEF) was evaluated through echocardiography before and after chemotherapy. Blood cTnT and CK-MB levels were measured using immunoluminescence. The incidence of adverse reactions during chemotherapy was also analyzed. Univariate analysis was performed to identify patients with cardiotoxic events, and multiple logistic regression analysis was done to study the efects of Doxorubicin, Epirubicin, Liposomal Doxorubicin, and their dosages on cardiotoxicity in patients.
Results The general records between the two groups showed no signifcant diferences (P>0.05). However, at the fourth cycle of chemotherapy, the observation group exhibited a lower LVEF (P<0.05), and a higher percentage of LVEF decrease compared to the control group (P<0.05). Moreover, the observation group had higher levels of blood cTnT and CK-MB (P<0.05). The incidence of cardiotoxicity in the observation group was also higher (P<0.05), but no signifcant diferences were seen in other adverse reaction rates (P>0.05). The occurrence of cardiotoxicity was found to be related to the choice and dosage of chemotherapy drugs (P<0.05), but not signifcantly correlated with age, sex, and mediastinal irradiation in patients (P>0.05). Furthermore, the use of Doxorubicin, Epirubicin, and Liposomal Doxorubicin in chemotherapy, as well as an increase in their dosages, was found to elevate the risk of cardiotoxicity in osteosarcoma patients (P<0.05). However, age, sex, and mediastinal radiation were not signifcantly associated with cardiotoxicity in osteosarcoma patients (P>0.05).
Conclusion We demonstrated that Doxorubicin, Epirubicin, Liposomal Doxorubicin (Anthracycline), and other drugs adversely afected cardiac function in osteosarcoma patients, increasing the risk of cardiac toxicity. Therefore, close monitoring of cardiac function during chemotherapy is crucial, and timely adjustments to the chemotherapy regimen are necessary. In addition, rational control of drug selection and dosage is essential to minimize the occurrence of cardiac toxicity.
