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A study of assessing cardiotoxicity by MUGA technique in patients treated for carcinoma breast

Journal: International Archives of Integrated Medicine (IAIM) (Vol.3, No. 10)

Publication Date:

Authors : ; ; ;

Page : 272-279

Keywords : Cardiotoxicity; MUGA technique; Carcinoma of breast.;

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Introduction: Adriamycin is one of the commonly used chemotherapeutic drugs in breast cancer which induce cardiotoxicity ranges from benign arrhythmias to potentially lethal cardiomyopathy. Aim: To study on assessing adriamycin induced early cardiotoxicity in breast cancer with MUGA scan by estimating LVEF. Materials and methods: In this prospective study with a subject of 30 female patients, histologically confirmed breast cancer stage-I –III without any co-morbidities and higher risk factors (as per protocol) with baseline LVEF >50% estimated with TC-99M MUGA scan and 2D Echo received 4 cycles of AC + RT + Paclitoxal + HT. Chemotherapy given based on BSA with dosage of A=60 mg/m2, C = 600 mg/m2; EBRT = 5040 Gy/5000 gy to chest wall and p=175 mg/m2. Results: Out of 30 patients, 4 patients received320 mg; 14 patients received 360 mg; 4 patients received 380 mg; 5 patients received 400 mg; 1 patient received 340 mg; 1 patient received 450 mg and 1 patient received 600 mg. In all the patients there is a decline in LVEF from baseline to 1st MUGA scan and Baseline to 2nd MUGA scan. From baseline - 2nd MUGA scan out of 30 patient, 3 patients had protocol defined decline LVEF i.e. <50% at doses of 380 mg, 400mg and 600 mg respectively i.e. 3 patients developed protocol defined subclinical cardiotoxicity. 2D Echo was also done in all patients at 3rd MUGA scan. In 2D Echo even though there is a decline in LVEF, no patient developed protocol defined subclinical cardiotoxicity. Mean and standard deviation (SD) was 51.97±2.72 for MUGA-3 based on null lypothesis, p value is scored as = 0.9 which is insignificant for adriamycin cardiotoxicity. Conclusions: Out weighing the benefits and risks at lower cumulative doses, adriamycin is still considered as treatment of choice. Specific cardiac monitoring guidelines should be formed to evaluate adriamycin cardiotoxicity.

Last modified: 2017-03-20 14:59:51