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Evidence summaries

Different Dosage Schedules for Reducing Cardiotoxicity in Cancer Patients Receiving Anthracycline Chemotherapy

An anthracycline infusion duration of six hours or longer reduces the risk of clinical heart failure. Level of evidence: "A"

A Cochrane review [Abstract] 1 included 11 studies with a total of 6083 subjects; 7 studies (n=803) examined different anthracycline infusion durations and 4 studies (n=5280) examined different anthracycline peak doses. The majority of patients in these studies were adults with different solid tumours. A lower rate of clinical heart failure with an infusion duration of 6 hours or longer was found as compared to a shorter infusion duration (RR = 0.27; 95% CI 0.09 to 0.81, 5 studies, 557 patients). For different anthracycline peak doses 2 studies addressing a doxorubicin peak dose of less than 60 mg/m2 versus 60 mg/m2 or more, 1 study addressing a liposomal doxorubicin peak dose of 25 mg/m2 versus 50 mg/m2 and 1 study addressing an epirubicin peak dose of 83 mg/m2 versus 110 mg/m2 were identified. In none of the studies a significant difference in the occurrence of clinical heart failure was identified.

    References

    • van Dalen EC, van der Pal HJ, Kremer LC. Different dosage schedules for reducing cardiotoxicity in people with cancer receiving anthracycline chemotherapy. Cochrane Database Syst Rev 2016;(3):CD005008. [PubMed]

Primary/Secondary Keywords