CARDIOTOXICITY FROM INTENSIVE CHEMOTHERAPY COMBINED WITH RADIOTHERAPYIN BREAST-CANCER

Cardiac function was evaluated in 86 breast cancer patients after stan dard chemotherapy, followed by ablative chemotherapy and chest irradia tion. One patient died of subacute heart failure 3 months after ablati ve chemotherapy. At a minimum of 1 year's follow-up (range 1-11 years) left vertricular ejection fraction (LVEF) was marginally abnormal in 4 of 27 disease-free survivors. One exceptional patient who received t wo transplantations is alive, with serious heart failure occurring aft er the second ablative chemotherapy. Including this patient, the perce ntage of patients free of clinical and subclinical cardiac dysfunction at 7 years is 78% (95% CI 61-95%). After ablative chemotherapy, cardi otoxicity was rarely life-threatening. The impact of subclinical cardi otoxicity in the long term is not clear and needs continued evaluation .