THE ROLE OF CHEMOTHERAPY IN CANCER PATIENTS WITH A SIGNIFICANT BURDEN OF CARDIOVASCULAR DISEASES

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Article Title:	THE ROLE OF CHEMOTHERAPY IN CANCER PATIENTS WITH A SIGNIFICANT BURDEN OF CARDIOVASCULAR DISEASES
Authors:	Melinda Csapo Gheorghe1*, Liviu Lazăr2, Silviu Corbu3, Simona Bungău2, Steliana Roxana Miclăuş4
Affiliation:	1*Farmimpex Pharmacy, Oradea, Romania 2Faculty of Medicine and Pharmacy, University of Oradea, Oradea 3Clinical Municipal Hospital, Oradea 4Faculty of Medicine, Transilvania University, Brașov, Romania
Abstract:	Chemotherapy treatment requires an adequate cardiovascular status, which most often is impaired. The purpose of this study was to demonstrate the feasability of tailored treatment with curative intent and to define clinical indicators that could have a significant impact within the multimodal approach. Patients from the hematology and medical oncology departments have been prospectively included for a period of one year and a subset was also retrospectively analyzed for a period of two years. Treatment side effects have been encoded using an adapted variant of common terminology criteria for adverse events. Statistical analysis focused primarily on qualitative data followed by quantitative analysis. A number of 81 oncological and 66 hematological patients were included, most of them with stage iv disease (60.5% and 31.8%, respectively). A small number of 13 (8.8%) patients have been without non-cardiovascular patient’s pathological background (PPB). A significant number of 112 (76.2%) patients presented cardiovascular. 107 (72,8%) patients underwent one line of chemotherapy. During chemotherapy, 91 (61.9%) patients developed cardiovascular adverse effects (AE). Patients with hormonal and radiation treatment had a significant higher risk for cardiovascular AE (OR 3.54, p<0.05). Similarly, patients with 3+ cardiovascular PPB had a significantly higher risk of developing AE (OR 3.15, p<0.05). Evaluation of NT-proBNP indicated a shorter study period with 4.6 months (p=0.044). D-dimers over a clinically significant threshold indicated a higher risk for cardiovascular AE (OR 3.11, p=0.03). The median active chemotherapy period was 3.61 months, significantly shorter than the follow up period of 6.84 months (p=0.01). This study demonstrated the feasibility of tailored treatment with curative intent in patients with a significant burden of disease. Published studies have been scarce larger prospective studies are encouraged.
Keywords:	cardiovascular, comorbidity, advanced stage, cancer, tailored treatment.
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*Correspondence:	1*Farmimpex Pharmacy, Oradea, Republicii Street 26, Romania, e-mail csapo_meli@freemail.hu, Phone number 0748696404 2Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Piata 1 Decembrie Street 10, Romania, e-mail lazarlv@yahoo.com, Phone number 0741521060 3Clinical Municipal Hospital, Oradea, Corneliu Coposu Street 12, Romania, e-mail smcorbu@yahoo.com, Phone number 0751157577 4Faculty of Medicine, Transilvania University, Brașov, Nicolae Balcescu Street 56, Romania e-mail roxileta2009@yahoo.com, Phone number 0727797777