| 梁莉,张淑兰,张照辉,等.联合放、化疗与单一化疗对乳腺癌患者心电图的影响[J].中华放射医学与防护杂志,2005,25(3):262-264.LIANG Li,ZHANG Shu-lan,ZHANG Zhao-hui,et al.Comparative analyses of the effect of radiotherapy and chemotherapy or chemotherapy alone on patients' electrocardiogram.[J].Chin J Radiol Med Prot,2005,25(3):262-264 |
| 联合放、化疗与单一化疗对乳腺癌患者心电图的影响 |
| Comparative analyses of the effect of radiotherapy and chemotherapy or chemotherapy alone on patients' electrocardiogram. |
| 投稿时间：2005-03-17 |
| DOI： |
| 中文关键词: 心脏毒性 放疗 表阿霉素 紫杉醇 |
| 英文关键词:Cardiotoxicity Radiotherapy Epirubicin Paclitaxel |
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| 中文摘要: |
| 目的 分析联合放、化疗与单一化疗的乳腺癌患者心电图变化特点,为放、化疗联合治疗所致心脏毒性预测提供参考。方法 1998年1月至2004年6月在我科住院接受含表阿霉素、紫杉醇方案化疗或联合放疗的术后乳腺癌患者共47例,其中联合放、化疗组(简称联合组)29例,单一化疗组(非联合组)18例。观察治疗后两组患者心电图变化特点及其相关因素,如年龄、既往史、肿瘤部位及表阿霉素、紫杉醇和放疗剂量等。结果 联合组11例(37.9%)心电图异常,非联合组2例(11.1%),两组比较,差异有统计学意义(z=-1.977,P=0.048)。异常的心电图种类较多,没有特征性改变。联合组异常心电图出现的时间为放疗后序贯化疗2个周期后(总的化疗周期为4～5个周期),非联合组为化疗第5～7个周期出现。提示放、化疗联合治疗心脏受损的比例增加,从而降低患者对化疗的耐受性。年龄>60岁的患者出现异常心电图的比率高于年龄≤60岁患者(z=-2.094P=0.036)。统计学上没有显示心电图的异常与患者高血压病史、肿瘤部位、放化疗的剂量相关。但合并高血压的乳腺癌患者出现心电图异常比率(54.5%)高于无高血压病史者(27.8%)。结论 放疗增加表阿霉素与紫杉醇的心脏毒性,降低了其耐受剂量,同时提示在放化疗期间定期复查心电图,尤其对年龄>60岁和有高血压病史的患者尤其重要,出现心电图改变的患者不宜再用表阿霉素及紫杉醇治疗。 |
| 英文摘要: |
| Objective To investigate the change of breast cancer patients' electrocardiogram during combined radiotherapy and chemotherapy or chemotherapy alone for the sake of predicting the cardiotoxictiy of combined radiotherapy and chemotherapy. Methods From January, 1998 to June, 2004, 47postoperative breast cancer patients were enrolled. Among them 29 patients received chemotherapy combined with radiotherapy (combinative group), and 18 patients received chemotherapy alone (non combinative group). The changes of electrocardiogram were observed and correlation factors were analyzed. Results Abnormal electrocardiograms were noted in 11 (37.9%) and 2 patients(11.1%) of the combinative group and the non-combinative group respectively(z=-1.977,P=0.048). In the combinative group, heart events were significantly increased in patients above 60 years old (z=-2.094 P=0.036). The changes of electrocardiogram were not significantly correlative with hypertension history, tumor site, dose of radiotherapy or chemotherapeutic drugs. But the incidence of abnormal electrocardiogram was higher in patients with a hypertension history than in those without it (54.5% vs 27.8%). Conclusion The abnormalities of electrocardiogram were are more frequent in patients treated with both raditiotherapy combined with chemotherapy. Our results suggest that breast cancer patients should be regularly reexamined with electrocardiography during therapy, especially whose age was those have a hypertension history and above 60 years old. |
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