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第54回・2016年・横浜
 

Retrospective analysis of cardiovascular diseases related to chemotherapies for advanced solid tumor patients

演題番号 : WS83-5

[筆頭演者]
白川 剛:1 
[共同演者]
中野 倫孝:2、二尾 健太:2、田村 真吾:3、薦田 正人:4、内野 慶太:4、小田代 敬太:2、在田 修二:5、柴田 義宏:6、有山 寛:2、草場 仁志:2、赤司 浩一:2、馬場 英司:5

1:県立宮崎病院・内科・化学療法科、2:九州大学・病院・血液・腫瘍内科、3:九州大学・病院別府病院・内科、4:独立行政法人国立病院機構九州医療センター・腫瘍内科、5:九州大学・大学院医学研究院・九州連携臨床腫瘍学、6:社会医療法人財団池友会福岡和白病院・腫瘍内科

 

Backgrounds: Appropriate management of cardiovascular diseases (CVDs) related to chemotherapy for solid tumors is important for safe oncologic treatment. However, prediction of the onset and progression of CVDs has not been generally established in Japan.
Methods: We conducted a retrospective analysis of advanced or recurrent solid tumor patients who received chemotherapies in a single institution. Patient characteristics, chemotherapy regimens, adverse events, CVDs prior to chemotherapy, and diagnosis of CVDs in association with chemotherapy were surveyed.
Results: During the period from April 2006 to March 2012, 394 patients were examined. Cardiac diseases (CD), hypertension, or arterial thrombosis or venous thromboembolism (TE) were seen in 37 (9.4%), 22 (5.6%), five (1.3%), and 14 (3.5%) cases, respectively. Hypertension (14.5%) and venous thrombosis (5.8%) were frequent in patients who received bevacizumab-containing chemotherapy. Four cases with left ventricular dysfunction experienced a decrease of ejection fraction (EF) and early filling/atrial filling (E/A), and E/A tended to decrease before EF. Ninety (62.1%) of 145 cases showed an elevation of D-dimer (DD) level prior to chemotherapy, and a further increase in DD level was seen when venous thrombosis occurred. Relative risks of the disease progression of hypertension, CD and TE due to chemotherapy were 1.3, 1.9 and 3.6 respectively.
Conclusions: A decrease in E/A and an increase in DD were suggested to be valuable for early diagnosis of the respective onsets of left ventricular dysfunction and venous thrombosis related to chemotherapy. We conclude that patients with previous CD tend to have disease progression of CD during chemotherapy.

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臓器別:その他

手法別:化学療法

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