门控平衡心室造影对靶向治疗癌症左心室功能的评价

中华核医学与分子影像杂志 Pub Date : 2019-10-25 DOI:10.3760/CMA.J.ISSN.2095-2848.2019.10.003

Chen Chen, Bin Sun, Si-long Hu, Xincun Wang, Yongping Zhang, YingJian Zhang

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引用次数: 0

摘要

目的观察门控平衡心室造影对靶向治疗乳腺癌症左室功能变化的评价作用。方法2016年2月至2017年12月，前瞻性纳入60例女性癌症患者（年龄：28-65（48.7±9.4）岁）。患者分为2组：拉帕替尼联合紫杉烯类化疗组（A组；n=25，年龄：29-65（47.8±11.3）岁）和拉帕替尼单药治疗组（B组；n=35，年龄：31-62（51.1±8.5）岁）。所有患者在治疗前和治疗后6/12个月均接受了门控平衡心室造影。观察左心室功能参数，包括左心室射血分数（LVEF）、峰值射血率（PER）、峰值充盈率（PFR）、1/3射血分数、1/3充盈分数、达到峰值时间（TPER）和峰值充盈时间（TPFR）。重复测量方差分析、独立样本t检验和Wilcoxon秩和检验。结果A组治疗后12个月的PER（（3.11±0.48）舒张末期容积（EDV）/s）低于治疗前（（3.60±0.62）EDV/s；F=3.447，t=0.60，P 0.05）；治疗后6个月（3.07±0.71）EDV/s）和12个月（2.84±0.54）EDV/s）的PFR与治疗前（3.57±0.81）EDV/s相比显著下降；F=5.345，t=0.82和0.75，均P<0.05）。B组治疗后12个月PFR（（2.86±0.55）EDV/s）较治疗前（（3.23±0.87）EDV/s）显著下降；F=3.214，t=0.84，P<0.05）。治疗后6个月和12个月，A组PFR的下降幅度大于B组（-0.37（-0.780.15）vs-0.13（-0.440.17）EDV/s；z=-1.569，P＜0.05）。PER和PFR在评估心脏功能变化方面可能比其他参数更敏感。拉帕替尼联合紫杉烯类化疗比拉帕替尼单药治疗更能更早地影响舒张功能。关键词：乳腺肿瘤；分子靶向治疗；心脏毒性；左心室功能；门控血池成像

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Evaluation of left ventricular function in breast cancer with targeted therapy by gated equilibration ventriculography

Objective To observe the evaluation function of gated equilibration ventriculography for the changes of left ventricular function in breast cancer with targeted therapy. Methods From February 2016 to December 2017, a total of 60 female breast cancer patients (age: 28-65 (48.7±9.4) years) were included prospectively. Patients were divided into 2 groups: lapatinib combined with taxeme-based chemotherapy group (group A; n=25, age: 29-65 (47.8±11.3) years) and lapatinib monotherapy group (group B; n=35, age: 31-62 (51.1±8.5) years). All patients underwent gated equilibration ventriculography before treatment and 6/12 months after treatment. The parameters of left ventricular function including left ventricle ejection fraction (LVEF), peak ejection rate (PER), peak filling rate (PFR), 1/3 ejection fraction (EF), 1/3 filling fraction (FF), time to peak ejection rate (TPER) and time of peak filling rate (TPFR) were observed. Repeated measurement analysis of variance, independent-samples t test and Wilcoxon rank sum test were performed. Results In group A, the PER at 12 months after treatment ((3.11±0.48) end-diastolic volume (EDV)/s) was lower than that before treatment ((3.60±0.62) EDV/s; F=3.447, t=0.60, P 0.05); the PFR at 6 months ((3.07±0.71) EDV/s) and 12 months after treatment ((2.84±0.54) EDV/s) declined significantly compared with that before treatment ((3.57±0.81) EDV/s; F=5.345, t=0.82 and 0.75, both P<0.05). In group B, the PFR at 12 months after treatment ((2.86±0.55) EDV/s) declined significantly compared with that before treatment ((3.23±0.87) EDV/s; F=3.214, t=0.84, P<0.05). The decrease of PFR at 6 months and 12 months after treatment in group A was greater than that in group B (-0.37(-0.78, 0.15) vs -0.13(-0.44, 0.17) EDV/s; z=-1.569, P<0.05). Conclusions The gated equilibration ventriculography can effectively monitor the left ventricular function of breast cancer patients after targeted therapy. PER and PFR may be more sensitive than other parameters to assess heart function changes. The lapatinib combined with taxeme-based chemotherapy can affect diastolic function more and earlier than lapatinib monotherapy. Key words: Breast neoplasms; Molecular targeted therapy; Cardiotoxicity; Ventricular function, left; Gated blood-pool imaging

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来源期刊

中华核医学与分子影像杂志核医学，分子影像

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发文量

5088

期刊介绍： Chinese Journal of Nuclear Medicine and Molecular Imaging (CJNMMI) was established in 1981, with the name of Chinese Journal of Nuclear Medicine, and renamed in 2012. As the specialized periodical in the domain of nuclear medicine in China, the aim of Chinese Journal of Nuclear Medicine and Molecular Imaging is to develop nuclear medicine sciences, push forward nuclear medicine education and basic construction, foster qualified personnel training and academic exchanges, and popularize related knowledge and raising public awareness. Topics of interest for Chinese Journal of Nuclear Medicine and Molecular Imaging include: -Research and commentary on nuclear medicine and molecular imaging with significant implications for disease diagnosis and treatment -Investigative studies of heart, brain imaging and tumor positioning -Perspectives and reviews on research topics that discuss the implications of findings from the basic science and clinical practice of nuclear medicine and molecular imaging - Nuclear medicine education and personnel training - Topics of interest for nuclear medicine and molecular imaging include subject coverage diseases such as cardiovascular diseases, cancer, Alzheimer’s disease, and Parkinson’s disease, and also radionuclide therapy, radiomics, molecular probes and related translational research.