Journal Article
. 2009 Jan; 20(3):437-40.
doi: 10.1093/annonc/mdn652.

Decline in pulmonary function in patients with breast cancer receiving dose-dense chemotherapy: a prospective study

R Yerushalmi 1 M R Kramer  S Rizel  A Sulkes  K Gelmon  T Granot  V Neiman  S M Stemmer  
Affiliations
  • PMID: 19139179
  •     7 citations

Abstract

Background: Prompted by complaints of dyspnea in breast cancer patients receiving adjuvant dose-dense chemotherapy (DDC), we sought to evaluate the possible association of DDC with pulmonary dysfunction.

Patients And Methods: A total of 34 consecutive patients receiving adjuvant DDC were enrolled. The chemotherapy regimen consisted of i.v. doxorubicin 60 mg/m(2) and cyclophosphamide 600 mg/m(2) (AC) every 14 days x4 with growth factor support followed by weekly i.v. paclitaxel 80 mg/m(2) x12. The following parameters were prospectively measured before and after the AC protocol (P1, P2) and at completion of paclitaxel treatment (P3): presence of dyspnea, blood pressure, pulse rate, hemoglobin, erythrocyte sedimentation rate, C-reactive protein level, cardiac ejection fraction, and pulmonary function. Repeated measures analysis was used to evaluate differences among the time points, and paired t-test was used to evaluate differences between consecutive time points.

Results: Although only five patients (15%) complained of dyspnea, there was a significant decrease in mean carbon monoxide diffusing capacity (DLCO), in all patients from P1 (22.09 ml/min/mmHg) to P3 (15 ml/min/mmHg) and in 29 of 32 patients (90.6%) from P1 to P2 (15.96 ml/min/mmHg) (P<0.001).

Conclusions: DDC is associated with a statistical significant reduction in DLCO. Awareness of this potential toxicity may be important in women with preexisting lung disease.

Accelerated hypofractionated radiotherapy as adjuvant regimen after conserving surgery for early breast cancer: interim report of toxicity after a minimum follow up of 3 years.
Paola PinnarĂ², Antonella Soriani, +6 authors, Lidia Strigari.
J Exp Clin Cancer Res, 2010 Jan 27; 29. PMID: 20100335    Free PMC article.
The Role of Supportive Therapy in the Era of Modern Adjuvant Treatment - Current and Future Tools.
Rupert Bartsch, Guenther G Steger.
Breast Care (Basel), 2009 Jan 01; 4(3). PMID: 20847876    Free PMC article.
Dose-dense chemotherapy in nonmetastatic breast cancer: a systematic review and meta-analysis of randomized controlled trials.
Luisa Bonilla, Irit Ben-Aharon, +3 authors, Salomon M Stemmer.
J Natl Cancer Inst, 2010 Nov 26; 102(24). PMID: 21098761    Free PMC article.
Systematic Review.
Chemotherapeutic agents increase the risk for pulmonary function test abnormalities in patients with multiple myeloma.
Jarrod T Bruce, Jerry M Tran, +5 authors, Karen L Wood.
Clin Lymphoma Myeloma Leuk, 2012 Sep 19; 12(5). PMID: 22986117    Free PMC article.
Increased cardiovascular risk factors in breast cancer survivors identified by routine measurements of body composition, resting heart rate and arterial blood pressure.
David H Jones, Melisa Nestore, +2 authors, Alain Steve Comtois.
Springerplus, 2014 May 03; 3. PMID: 24790808    Free PMC article.
Prospective Long-Term Follow-Up of Pulmonary Diffusion Capacity Reduction Caused by Dose-Dense Chemotherapy in Patients with Breast Cancer.
Yosef Landman, Salomon Marcello Stemmer, +6 authors, Rinat Yerushalmi.
J Oncol, 2019 Nov 28; 2019. PMID: 31772578    Free PMC article.
Effects of neoadjuvant chemotherapy on respiratory function in patients with breast cancer.
Lei Ding, Liping Wang, +2 authors, Zijing He.
Chin J Cancer Res, 2020 Mar 21; 32(1). PMID: 32194303    Free PMC article.