Vnitr Lek 2011, 57(5):472-484

Cardiotoxicity of cancer therapy

J. Marek1,*, A. Linhart1, Z. Rucklová1, J. Haber2, J. Kořínek1
1 II. interní klinika - klinika kardiologie a angiologie 1. lékařské fakulty UK a VFN Praha, přednosta prof. MUDr. Aleš Linhart, DrSc.
2 I. interní klinika - klinika hematologie 1. lékařské fakulty UK a VFN Praha, přednosta prof. MUDr. Marek Trněný, CSc.

Due to advances in oncological care, the number of patients exposed to and surviving after anticancer chemotherapy is steadily increasing. Anticancer agents, however, are often associated with side-effects including cardiotoxicity which has been identified as one of the most serious and potentially life threatening complications. Cardiotoxicity manifestations range from asymptomatic alterations of heart and vasculature function to arterial hypertension, myocardial ischemia, arrhythmias (including QT-prolongation) and overt heart failure. Post-chemotherapy cardiovascular impairment has been associated with increased morbidity and may also contribute to increased mortality in these patients, both early and late after chemotherapy. This review article describes pathophysiology, clinical manifestation, diagnostic algorithms, monitoring and therapy of cardiotoxicity caused by anticancer agents. We also outline and discuss a variety of problems associated with patient management from the viewpoint of clinical cardiology according to latest published findings.

Keywords: cardiotoxicity of cancer therapy; heart failure; myocardial ischemia; arrhythmias; arterial hypertension

Received: October 6, 2010; Accepted: November 26, 2010; Published: May 1, 2011  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Marek J, Linhart A, Rucklová Z, Haber J, Kořínek J. Cardiotoxicity of cancer therapy. Vnitr Lek. 2011;57(5):472-484.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. ÚZIS ČR. Zhoubné nádory v roce 2006. Aktuální informace Ústavu zdravotnických informací a statistiky České republiky 2009; 1: 1-9.
    2. Yeh ET, Bickford CL. Cardiovascular complications of cancer therapy: incidence, pathogenesis, diagnosis, and management. J Am Coll Cardiol 2009; 53: 2231-2247. Go to original source... Go to PubMed...
    3. Lefrak EA, Pitha J, Rosenheim S et al. A clinicopathologic analysis of adriamycin cardiotoxicity. Cancer 1973; 32: 302-314. Go to original source...
    4. Slamon DJ, Leyland-Jones B, Shak S et al. Use of chemotherapy plus a monoclonal antibody against HER2 for metastatic breast cancer that overexpresses HER2. N Engl J Med 2001; 344: 783-792. Go to original source... Go to PubMed...
    5. Chu TF, Rupnick MA, Kerkela R et al. Cardiotoxicity associated with tyrosine kinase inhibitor sunitinib. Lancet 2007; 370: 2011-2019. Go to original source... Go to PubMed...
    6. Khakoo AY, Kassiotis CM, Tannir N et al. Heart failure associated with sunitinib malate: a multitargeted receptor tyrosine kinase inhibitor. Cancer 2008; 112: 2500-2508. Go to original source... Go to PubMed...
    7. Miller KD, Chap LI, Holmes FA et al. Randomized phase III trial of capecitabine compared with bevacizumab plus capecitabine in patients with previously treated metastatic breast cancer. J Clin Oncol 2005; 23: 792-799. Go to original source... Go to PubMed...
    8. Kerkelä R, Grazette L, Yacobi R et al. Cardiotoxicity of the cancer therapeutic agent imatinib mesylate. Nat Med 2006; 12: 908-916. Go to original source... Go to PubMed...
    9. Gottdiener JS, Appelbaum FR, Ferrans VJ et al. Cardiotoxicity associated with high-dose cyclophosphamide therapy. Arch Intern Med 1981; 141: 758-763. Go to original source...
    10. Samlowski WE, Ward JH, Craven CM et al. Severe myocarditis following high-dose interleukin-2 administration. Arch Pathol Lab Med 1989; 113: 838-841.
    11. Sonnenblick M, Rosin A. Cardiotoxicity of interferon. A review of 44 cases. Chest 1991; 99: 557-561. Go to original source... Go to PubMed...
    12. Perez EA, Koehler M, Byrne J et al. Cardiac safety of lapatinib: pooled analysis of 3689 patients enrolled in clinical trials. Mayo Clin Proc 2008; 83: 679-686. Go to original source...
    13. Wu S, Chen JJ, Kudelka A et al. Incidence and risk of hypertension with sorafenib in patients with cancer: a systematic review and meta-analysis. Lancet Oncol 2008; 9: 117-123. Go to original source... Go to PubMed...
    14. Pande A, Lombardo J, Spangenthal E et al. Hypertension secondary to anti-angiogenic therapy: experience with bevacizumab. Anticancer Res 2007; 27: 3465-3470.
    15. Alter P, Herzum M, Soufi M et al. Cardiotoxicity of 5-fluorouracil. Cardiovasc Hematol Agents Med Chem 2006; 4: 1-5. Go to original source... Go to PubMed...
    16. Escudier B, Eisen T, Stadler WM et al. Sorafenib in advanced clear-cell renal-cell carcinoma. N Engl J Med 2007; 356: 125-134. Go to original source... Go to PubMed...
    17. Guglin M, Aljayeh M, Saiyad S et al. Introducing a new entity: chemotherapy-induced arrhythmia. Europace 2009; 11: 1579-1586. Go to original source... Go to PubMed...
    18. Scappaticci FA, Skillings JR, Holden SN et al. Arterial thromboembolic events in patients with metastatic carcinoma treated with chemotherapy and bevacizumab. J Natl Cancer Inst 2007; 99: 1232-1239. Go to original source... Go to PubMed...
    19. Jurcut R, Wildiers H, Ganame J et al. Detection and monitoring of cardiotoxicity-what does modern cardiology offer? Support Care Cancer 2008; 16: 437-445. Go to original source... Go to PubMed...
    20. Schwartz RG, McKenzie WB, Alexander J et al. Congestive heart failure and left ventricular dysfunction complicating doxorubicin therapy. Seven-year experience using serial radionuclide angiocardiography. Am J Med 1987; 82: 1109-1118. Go to original source... Go to PubMed...
    21. Wadhwa D, Fallah-Rad N, Grenier D et al. Trastuzumab mediated cardiotoxicity in the setting of adjuvant chemotherapy for breast cancer: a retrospective study. Breast Cancer Res Treat 2009; 117: 357-364. Go to original source... Go to PubMed...
    22. Dolci A, Dominici R, Cardinale D et al. Biochemical markers for prediction of chemotherapy-induced cardiotoxicity: systematic review of the literature and recommendations for use. Am J Clin Pathol 2008; 130: 688-695. Go to original source... Go to PubMed...
    23. Billingham ME, Mason JW, Bristow MR et al. Anthracycline cardiomyopathy monitored by morphologic changes. Cancer Treat Rep 1978; 62: 865-872. Go to PubMed...
    24. Valdés Olmos RA, Carrió I, Hoefnagel CA et al. High sensitivity of radiolabelled antimyosin scintigraphy in assessing anthracycline related early myocyte damage preceding cardiac dysfunction. Nucl Med Commun 2002; 23: 871-877. Go to original source... Go to PubMed...
    25. Hensley ML, Hagerty KL, Kewalramani T et al. American Society of Clinical Oncology 2008 clinical practice guideline update: use of chemotherapy and radiation therapy protectants. J Clin Oncol 2009; 27: 127-145. Go to original source... Go to PubMed...
    26. Chen B, Peng X, Pentassuglia L et al. Molecular and cellular mechanisms of anthracycline cardiotoxicity. Cardiovasc Toxicol 2007; 7: 114-121. Go to original source... Go to PubMed...
    27. Shan K, Lincoff AM, Young JB. Anthracycline-induced cardiotoxicity. Ann Intern Med 1996; 125: 47-58. Go to original source... Go to PubMed...
    28. Bristow MR, Thompson PD, Martin RP et al. Early anthracycline cardiotoxicity. Am J Med 1978; 65: 823-832. Go to original source... Go to PubMed...
    29. Von Hoff DD, Layard MW, Basa P et al. Risk factors for doxorubicin-induced congestive heart failure. Ann Intern Med 1979; 91: 710-717. Go to original source... Go to PubMed...
    30. Swain SM, Whaley FS, Ewer MS. Congestive heart failure in patients treated with doxorubicin: a retrospective analysis of three trials. Cancer 2003; 97: 2869-2879. Go to original source... Go to PubMed...
    31. Haq MM, Legha SS, Choksi J et al. Doxorubicin-induced congestive heart failure in adults. Cancer 1985; 56: 1361-1365. Go to original source...
    32. Jensen BV, Skovsgaard T, Nielsen SL. Functional monitoring of anthracycline cardiotoxicity: a prospective, blinded, long-term observational study of outcome in 120 patients. Ann Oncol 2002; 13: 699-709. Go to original source... Go to PubMed...
    33. Steinherz LJ, Steinherz PG, Tan CT et al. Cardiac toxicity 4 to 20 years after completing anthracycline therapy. JAMA 1991; 266: 1672-1677. Go to original source...
    34. Lipshultz SE, Colan SD, Gelber RD et al. Late cardiac effects of doxorubicin therapy for acute lymphoblastic leukemia in childhood. N Engl J Med 1991; 324: 808-815. Go to original source... Go to PubMed...
    35. van Dalen EC, van der Pal HJ, Kok WE et al. Clinical heart failure in a cohort of children treated with anthracyclines: a long-term follow-up study. Eur J Cancer 2006; 42: 3191-3198. Go to original source... Go to PubMed...
    36. Chen MH, Kerkelä R, Force T. Mechanisms of cardiac dysfunction associated with tyrosine kinase inhibitor cancer therapeutics. Circulation 2008; 118: 84-95. Go to original source... Go to PubMed...
    37. Guarneri V, Lenihan DJ, Valero V et al. Long-term cardiac tolerability of trastuzumab in metastatic breast cancer: the M.D. Anderson Cancer Center experience. J Clin Oncol 2006; 24: 4107-4115. Go to original source... Go to PubMed...
    38. Tan-Chiu E, Yothers G, Romond E et al. Assessment of cardiac dysfunction in a randomized trial comparing doxorubicin and cyclophosphamide followed by paclitaxel, with or without trastuzumab as adjuvant therapy in node-positive, human epidermal growth factor receptor 2-overexpressing breast cancer: NSABP B-31. J Clin Oncol 2005; 23: 7811-7819. Go to original source... Go to PubMed...
    39. Perez EA, Suman VJ, Davidson NE et al. Cardiac safety analysis of doxorubicin and cyclophosphamide followed by paclitaxel with or without trastuzumab in the North Central Cancer Treatment Group N9831 adjuvant breast cancer trial. J Clin Oncol 2008; 26: 1231-1238. Go to original source... Go to PubMed...
    40. Telli ML, Hunt SA, Carlson RW et al. Trastuzumab-related cardiotoxicity: calling into question the concept of reversibility. J Clin Oncol 2007; 25: 3525-3533. Go to original source... Go to PubMed...
    41. Bianchi G, Albanell J, Eiermann W et al. Pilot trial of trastuzumab starting with or after the doxorubicin component of a doxorubicin plus paclitaxel regimen for women with HER2-positive advanced breast cancer. Clin Cancer Res 2003; 9: 5944-5951.
    42. Untch M, Muscholl M, Tjulandin S et al. First-line trastuzumab plus epirubicin and cyclophosphamide therapy in patients with human epidermal growth factor receptor 2-positive metastatic breast cancer: cardiac safety and efficacy data from the Herceptin, Cyclophosphamide, and Epirubicin (HERCULES) trial. J Clin Oncol 2010; 28: 1473-1480. Go to original source... Go to PubMed...
    43. Miller K, Wang M, Gralow J et al. Paclitaxel plus bevacizumab versus paclitaxel alone for metastatic breast cancer. N Engl J Med 2007; 357: 2666-2676. Go to original source... Go to PubMed...
    44. Atallah E, Durand JB, Kantarjian H et al. Congestive heart failure is a rare event in patients receiving imatinib therapy. Blood 2007; 110: 1233-1237. Go to original source... Go to PubMed...
    45. Minow RA, Benjamin RS, Lee ET et al. Adriamycin cardiomyopathy - risk factors. Cancer 1977; 39: 1397-1402. Go to original source...
    46. Braverman AC, Antin JH, Plappert MT et al. Cyclophosphamide cardiotoxicity in bone marrow transplantation: a prospective evaluation of new dosing regimens. J Clin Oncol 1991; 9: 1215-1223. Go to original source... Go to PubMed...
    47. Lee RE, Lotze MT, Skibber JM et al. Cardiorespiratory effects of immunotherapy with interleukin-2. J Clin Oncol 1989; 7: 7-20. Go to original source... Go to PubMed...
    48. White RL Jr, Schwartzentruber DJ, Guleria A et al. Cardiopulmonary toxicity of treatment with high dose interleukin-2 in 199 consecutive patients with metastatic melanoma or renal cell carcinoma. Cancer 1994; 74: 3212-3222. Go to original source...
    49. Salman H, Bergman M, Bessler H et al. The effect of interferon on mouse myocardial capillaries: an ultrastructural study. Cancer 1999; 85: 1375-1379. Go to original source...
    50. Dorr RT, Shipp NG. Effect of interferon, interleukin-2 and tumor necrosis factor on myocardial cell viability and doxorubicin cardiotoxicity in vitro. Immunopharmacology 1989; 18: 31-38. Go to original source... Go to PubMed...
    51. Zimmerman S, Adkins D, Graham M et al. Irreversible, severe congestive cardiomyopathy occurring in association with interferon alpha therapy. Cancer Biother 1994; 9: 291-299. Go to original source... Go to PubMed...
    52. Kruit WH, Punt KJ, Goey SH et al. Cardiotoxicity as a dose-limiting factor in a schedule of high dose bolus therapy with interleukin-2 and alpha-interferon. An unexpectedly frequent complication. Cancer 1994; 74: 2850-2856. Go to original source...
    53. van Dalen EC, van der Pal HJ, Caron HN et al. Different dosage schedules for reducing cardiotoxicity in cancer patients receiving anthracycline chemotherapy. Cochrane Database Syst Rev 2009; 7: CD005008. Go to original source... Go to PubMed...
    54. Weiss AJ, Metter GE, Fletcher WS et al. Studies on adriamycin using a weekly regimen demonstrating its clinical effectiveness and lack of cardiac toxicity. Cancer Treat Rep 1976; 60: 813-822. Go to PubMed...
    55. van Dalen EC, Michiels EM, Caron HN et al. Different anthracycline derivates for reducing cardiotoxicity in cancer patients. Cochrane Database Syst Rev 2006; 4: CD005006. Go to original source... Go to PubMed...
    56. Hershman DL, McBride RB, Eisenberger A et al. Doxorubicin, cardiac risk factors, and cardiac toxicity in elderly patients with diffuse B-cell non-Hodgkin's lymphoma. J Clin Oncol 2008; 26: 3159-3165. Go to original source... Go to PubMed...
    57. Lipshultz SE, Lipsitz SR, Mone SM et al. Female sex and drug dose as risk factors for late cardiotoxic effects of doxorubicin therapy for childhood cancer. N Engl J Med 1995; 332: 1738-1743. Go to original source... Go to PubMed...
    58. Suter TM, Procter M, van Veldhuisen DJ et al. Trastuzumab-associated cardiac adverse effects in the herceptin adjuvant trial. J Clin Oncol 2007; 25: 3859-3865. Go to original source... Go to PubMed...
    59. van Dalen EC, Caron HN, Dickinson HO et al. Cardioprotective interventions for cancer patients receiving anthracyclines. Cochrane Database Syst Rev 2008; 2: CD003917. Go to original source... Go to PubMed...
    60. Swain SM, Whaley FS, Gerber MC et al. Cardioprotection with dexrazoxane for doxorubicin-containing therapy in advanced breast cancer. J Clin Oncol 1997; 15: 1318-1332. Go to original source... Go to PubMed...
    61. Kalay N, Basar E, Ozdogru I et al. Protective effects of carvedilol against anthracycline-induced cardiomyopathy. J Am Coll Cardiol 2006; 48: 2258-2262. Go to original source... Go to PubMed...
    62. Cardinale D, Colombo A, Sandri MT et al. Prevention of high-dose chemotherapy-induced cardiotoxicity in high-risk patients by angiotensin-converting enzyme inhibition. Circulation 2006; 114: 2474-2481. Go to original source... Go to PubMed...
    63. Nakamae H, Tsumura K, Terada Y et al. Notable effects of angiotensin II receptor blocker, valsartan, on acute cardiotoxic changes after standard chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisolone. Cancer 2005; 104: 2492-2498. Go to original source... Go to PubMed...
    64. Isner JM, Ferrans VJ, Cohen SR et al. Clinical and morphologic cardiac findings after anthracycline chemotherapy. Analysis of 64 patients studied at necropsy. Am J Cardiol 1983; 51: 1167-1174. Go to original source... Go to PubMed...
    65. Ewer MS, Ali MK, Mackay B et al. A comparison of cardiac biopsy grades and ejection fraction estimations in patients receiving Adriamycin. J Clin Oncol 1984; 2: 112-117. Go to original source... Go to PubMed...
    66. Mitani I, Jain D, Joska TM et al. Doxorubicin cardiotoxicity: prevention of congestive heart failure with serial cardiac function monitoring with equilibrium radionuclide angiocardiography in the current era. J Nucl Cardiol 2003; 10: 132-139. Go to original source... Go to PubMed...
    67. O'Brien ME, Wigler N, Inbar M et al. Reduced cardiotoxicity and comparable efficacy in a phase III trial of pegylated liposomal doxorubicin HCl (CAELYX/Doxil) versus conventional doxorubicin for first-line treatment of metastatic breast cancer. Ann Oncol 2004; 15: 440-449. Go to original source... Go to PubMed...
    68. Harris L, Batist G, Belt R et al. Liposome-encapsulated doxorubicin compared with conventional doxorubicin in a randomized multicenter trial as first-line therapy of metastatic breast carcinoma. Cancer 2002; 94: 25-36. Go to original source... Go to PubMed...
    69. Batist G, Ramakrishnan G, Rao CS et al. Reduced cardiotoxicity and preserved antitumor efficacy of liposome-encapsulated doxorubicin and cyclophosphamide compared with conventional doxorubicin and cyclophosphamide in a randomized, multicenter trial of metastatic breast cancer. J Clin Oncol 2001; 19: 1444-1454. Go to original source... Go to PubMed...
    70. Suzuki J, Yanagisawa A, Shigeyama T et al. Early detection of anthracycline-induced cardiotoxicity by radionuclide angiocardiography. Angiology 1999; 50: 37-45. Go to original source... Go to PubMed...
    71. Hare JL, Brown JK, Leano R et al. Use of myocardial deformation imaging to detect preclinical myocardial dysfunction before conventional measures in patients undergoing breast cancer treatment with trastuzumab. Am Heart J 2009; 158: 294-301. Go to original source... Go to PubMed...
    72. Elbl L, Hrstkova H, Chaloupka V et al. The evaluation of left ventricular function in childhood cancer survivors by pharmacological stress echocardiography. Neoplasma 2003; 50: 191-197. Go to PubMed...
    73. Horacek JM, Pudil R, Jebavy L et al. Assessment of anthracycline-induced cardiotoxicity with biochemical markers. Exp Oncol 2007; 29: 309-313.
    74. Elbl L, Vasova I, Navratil M et al. Comparison of plasmatic levels of B-natriuretic peptide with echocardiographic indicators of left ventricle function after doxorubicin therapy. Vnitř Lék 2006; 52: 563-570. Go to PubMed...
    75. Cardinale D, Sandri MT, Martinoni A et al. Left ventricular dysfunction predicted by early troponin I release after high-dose chemotherapy. J Am Coll Cardiol 2000; 36: 517-522. Go to original source... Go to PubMed...
    76. Vogelsang TW, Jensen RJ, Hesse B et al. BNP cannot replace gated equilibrium radionuclide ventriculography in monitoring of anthracycline-induced cardiotoxity. Int J Cardiol 2008; 124: 193-197. Go to original source... Go to PubMed...
    77. Horacek JM, Vasatova M, Tichy M et al. The use of cardiac biomarkers in detection of cardiotoxicity associated with conventional and high-dose chemotherapy for acute leukemia. Exp Oncol 2010; 32: 97-99.
    78. Steinherz LJ, Graham T, Hurwitz R et al. Guidelines for cardiac monitoring of children during and after anthracycline therapy: report of the Cardiology Committee of the Childrens Cancer Study Group. Pediatrics 1992; 89: 942-949. Go to original source... Go to PubMed...
    79. Fox KF. The evaluation of left ventricular function for patients being considered for, or receiving Trastuzumab (Herceptin) therapy. Br J Cancer 2006; 95: 1454. Go to original source... Go to PubMed...
    80. Jones AL, Barlow M, Barrett-Lee PJ et al. Management of cardiac health in trastuzumab-treated patients with breast cancer: updated United Kingdom National Cancer Research Institute recommendations for monitoring. Br J Cancer 2009; 100: 684-692. Go to original source... Go to PubMed...
    81. Špinar J, Hradec J, Meluzín J et al. Doporučení pro diagnostiku a léčbu chronického srdečního selhání ČKS 2006. Cor Vasa 2007; 49: K5-K34.
    82. Noori A, Lindenfeld J, Wolfel E et al. Beta-blockade in adriamycin-induced cardiomyopathy. J Card Fail 2000; 6: 115-119. Go to original source... Go to PubMed...
    83. Oliveira PJ, Bjork JA, Santos MS et al. Carvedilol-mediated antioxidant protection against doxorubicin-induced cardiac mitochondrial toxicity. Toxicol Appl Pharmacol 2004; 200: 159-168. Go to original source... Go to PubMed...
    84. Ajijola OA, Nandigam KV, Chabner BA et al. Usefulness of cardiac resynchronization therapy in the management of Doxorubicin-induced cardiomyopathy. Am J Cardiol 2008; 101: 1371-1372. Go to original source... Go to PubMed...
    85. Saif MW, Tomita M, Ledbetter L et al. Capecitabine-related cardiotoxicity: recognition and management. J Support Oncol 2008; 6: 41-48. Go to PubMed...
    86. Sasson Z, Morgan CD, Wang B et al. 5-Fluorouracil related toxic myocarditis: case reports and pathological confirmation. Can J Cardiol 1994; 10: 861-864.
    87. Matsubara I, Kamiya J, Imai S. Cardiotoxic effects of 5-fluorouracil in the guinea pig. Jpn J Pharmacol 1980; 30: 871-879. Go to original source... Go to PubMed...
    88. Wacker A, Lersch C, Scherpinski U et al. High incidence of angina pectoris in patients treated with 5-fluorouracil. A planned surveillance study with 102 patients. Oncology 2003; 65: 108-112. Go to original source... Go to PubMed...
    89. Cwikiel M, Eskilsson J, Wieslander JB et al. The appearance of endothelium in small arteries after treatment with 5-fluorouracil. An electron microscopic study of late effects in rabbits. Scanning Microsc 1996; 10: 805-819. Go to PubMed...
    90. Labianca R, Beretta G, Clerici M et al. Cardiac toxicity of 5-fluorouracil: a study on 1083 patients. Tumori 1982; 68: 505-510. Go to original source... Go to PubMed...
    91. Kosmas C, Kallistratos MS, Kopterides P et al. Cardiotoxicity of fluoropyrimidines in different schedules of administration: a prospective study. J Cancer Res Clin Oncol 2008; 134: 75-82. Go to original source... Go to PubMed...
    92. Jensen SA, Sørensen JB. Risk factors and prevention of cardiotoxicity induced by 5-fluorouracil or capecitabine. Cancer Chemother Pharmacol 2006; 58: 487-493. Go to original source... Go to PubMed...
    93. Saif MW, Shah MM, Shah AR. Fluoropyrimidine-associated cardiotoxicity: revisited. Expert Opin Drug Saf 2009; 8: 191-202. Go to original source... Go to PubMed...
    94. Rezkalla S, Kloner RA, Ensley J et al. Continuous ambulatory ECG monitoring during fluorouracil therapy: a prospective study. J Clin Oncol 1989; 7: 509-514. Go to original source... Go to PubMed...
    95. Grandi AM, Pinotti G, Morandi E et al. Noninvasive evaluation of cardiotoxicity of 5-fluorouracil and low doses of folinic acid: a one-year follow-up study. Ann Oncol 1997; 8: 705-708. Go to original source... Go to PubMed...
    96. Kamba T, McDonald DM. Mechanisms of adverse effects of anti-VEGF therapy for cancer. Br J Cancer 2007; 96: 1788-1795. Go to original source... Go to PubMed...
    97. Guzzetti S, Costantino G, Vernocchi A et al. First diagnosis of colorectal or breast cancer and prevalence of atrial fibrillation. Intern Emerg Med 2008; 3: 227-231. Go to original source... Go to PubMed...
    98. Pudil R, Horacek JM, Horackova J et al. Anthracycline therapy can induce very early increase in QT dispersion and QTc prolongation. Leuk Res 2008; 32: 998-999. Go to original source... Go to PubMed...
    99. Naito K, Kobayashi M, Sahara N et al. Two cases of acute promyelocytic leukemia complicated by torsade de pointes during arsenic trioxide therapy. Int J Hematol 2006; 83: 318-323. Go to original source... Go to PubMed...
    100. Kishi S, Yoshida A, Yamauchi T et al. Torsade de pointes associated with hypokalemia after anthracycline treatment in a patient with acute lymphocytic leukemia. Int J Hematol 2000; 71: 172-179. Go to PubMed...
    101. Wortman JE, Lucas VS Jr, Schuster E et al. Sudden death during doxorubicin administration. Cancer 1979; 44: 1588-1591. Go to original source...
    102. Rixe O, Billemont B, Izzedine H. Hypertension as a predictive factor of Sunitinib activity. Ann Oncol 2007; 18: 1117. Go to original source... Go to PubMed...
    103. Hequet O, Le QH, Moullet I et al. Subclinical late cardiomyopathy after doxorubicin therapy for lymphoma in adults. J Clin Oncol 2004; 22: 1864-1871. Go to original source... Go to PubMed...
    104. Singal PK, Iliskovic N. Doxorubicin-induced cardiomyopathy. N Engl J Med 1998; 339: 900-905. Go to original source... Go to PubMed...
    105. Van Cutsem E, Hoff PM, Blum JL et al. Incidence of cardiotoxicity with the oral fluoropyrimidine capecitabine is typical of that reported with 5-fluorouracil. Ann Oncol 2002; 13: 484-485. Go to original source... Go to PubMed...

    Return to the content


    Vnitřní lékařství

    Madam, Sir,
    please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
    Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

    I declare:

    1. that I have met the above instruction
    2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited

    No
    Yes

    If your statement is not true, please be aware
    that brings the risk of danger to their health or the health of others.