PDF(Pubmed)
Abstract：
BACKGROUND: Breast cancer is a global health concern, with a significant portion of patients exhibiting human epidermal growth factor receptor 2 (HER2) overexpression. Trastuzumab is one of the pivotal therapies for HER2-positive breast cancer, but it carries the risk of cardiotoxicity. Guidelines for cardiac monitoring are essential to detect early signs of cardiotoxicity. However, adherence to these guidelines remains uncertain.
METHODS: In this single-center retrospective cohort study, we analyzed data from 167 female patients diagnosed with HER2-positive breast cancer who were treated with trastuzumab. We meticulously assessed the level of adherence to cardiac monitoring guidelines and determined the incidence of trastuzumab-induced cardiotoxicity (TIC). Factors affecting adherence were subsequently investigated using appropriate statistical methods.
RESULTS: Adherence to monitoring guidelines was only 31.7%. TIC incidence was 7.8%. Patients with concurrent use of cardiotoxic medications demonstrated higher adherence. A significant association was found between the number of trastuzumab doses and adherence.
CONCLUSIONS: Adherence to monitoring guidelines was suboptimal. Those at a higher risk of cardiac issues showed greater adherence. Improved risk assessment methods are needed to individualize monitoring and intervention. Future research should focus on patient-centered, evidence-based monitoring to optimize the balance between cancer therapy and cardiac safety in the field of cardio-oncology.
METHODS: In this single-center retrospective cohort study, we analyzed data from 167 female patients diagnosed with HER2-positive breast cancer who were treated with trastuzumab. We meticulously assessed the level of adherence to cardiac monitoring guidelines and determined the incidence of trastuzumab-induced cardiotoxicity (TIC). Factors affecting adherence were subsequently investigated using appropriate statistical methods.
RESULTS: Adherence to monitoring guidelines was only 31.7%. TIC incidence was 7.8%. Patients with concurrent use of cardiotoxic medications demonstrated higher adherence. A significant association was found between the number of trastuzumab doses and adherence.
CONCLUSIONS: Adherence to monitoring guidelines was suboptimal. Those at a higher risk of cardiac issues showed greater adherence. Improved risk assessment methods are needed to individualize monitoring and intervention. Future research should focus on patient-centered, evidence-based monitoring to optimize the balance between cancer therapy and cardiac safety in the field of cardio-oncology.
摘要：
背景：乳腺癌是全球健康问题，显着部分患者表现出人表皮生长因子受体2（HER2）过表达。曲妥珠单抗是HER2阳性乳腺癌的关键疗法之一，但它有心脏毒性的风险。心脏监测指南对于检测心脏毒性的早期迹象至关重要。然而,对这些准则的遵守仍不确定。
方法：在这项单中心回顾性队列研究中，我们分析了167例HER2阳性乳腺癌女性患者接受曲妥珠单抗治疗的数据.我们仔细评估了心脏监测指南的依从性，并确定了曲妥珠单抗诱导的心脏毒性（TIC）的发生率。随后使用适当的统计方法调查影响依从性的因素。
结果：对监测指南的依从性仅为31.7%。TIC发生率为7.8%。同时使用心脏毒性药物的患者表现出更高的依从性。发现曲妥珠单抗剂量数与依从性之间存在显著关联。
结论：对监测指南的依从性并不理想。那些心脏问题风险较高的患者表现出更高的依从性。需要改进风险评估方法，以个性化监测和干预。未来的研究应该集中在以患者为中心，基于证据的监测，以优化心脏肿瘤领域癌症治疗和心脏安全性之间的平衡。
方法：在这项单中心回顾性队列研究中，我们分析了167例HER2阳性乳腺癌女性患者接受曲妥珠单抗治疗的数据.我们仔细评估了心脏监测指南的依从性，并确定了曲妥珠单抗诱导的心脏毒性（TIC）的发生率。随后使用适当的统计方法调查影响依从性的因素。
结果：对监测指南的依从性仅为31.7%。TIC发生率为7.8%。同时使用心脏毒性药物的患者表现出更高的依从性。发现曲妥珠单抗剂量数与依从性之间存在显著关联。
结论：对监测指南的依从性并不理想。那些心脏问题风险较高的患者表现出更高的依从性。需要改进风险评估方法，以个性化监测和干预。未来的研究应该集中在以患者为中心，基于证据的监测，以优化心脏肿瘤领域癌症治疗和心脏安全性之间的平衡。
