the 12th kyoto breast cancer consensus conference ...questionnaire results theme “prevention and...

The 12th Kyoto Breast Cancer Consensus Conference

Questionnaire Results

Theme

“Prevention and Monitoring of Myocardial Toxicity”

Kyoto Breast Cancer Consensus Conference 2011/11/5

Saturday 5th November 2011

Corporate institutions for the questionnaire (27 institutes, in no particular order)


Shiga University of Medical Science

Kan Norimichi Clinic

Fukui Red Cross Hospital

Osaka Red Cross Hospital

Kansai Electric

Power Hospital

Takatsuki Red Cross Hospital

Kitano hospital

Himeji Medical Center

Kohka Public Hospital

Tenri Hospital

Japanese Red Cross Wakayama Medical

Center

Kyoto Medical Center

Kyoto City Hospital

Shinko Hospital

Kobe City Medical Center West

Hospital

Hyogo prefectual Tsukaguchi

Hospital

Obama Municipal Hospital

Kusatsu General

Hospital

Ijinkai Takeda

Hospital

Kyoto Breast Center Sawai Clinic

Nagahama City Hospital

Moriyama Medical

Center for Adults

Otsu Municipal

Hospital

Yamato Takada

Municipal Hospital

Kato Breast Surgery Clinic

Kurashiki Central Hospital

Kyoto University

Cardiotoxicity of anthracycline

• Risk Factors

–Cumulative Dose

–Age >70 or underlying heart disease

–Concurrent medications such as Taxane or Trastuzumab

–Prior RT


Back Ground－１

Back Ground-2

• Strong inhibitors of CYP3A4 increase blood concentration of concomitant drugs

• Calcium antagonist is metabolised by human liver cytochrome P450 3A4 (CYP3A4)

• The possibility of myocardial preservation effect is indicated for G-CSF


Q1. Age comparison of the cases where cardiotoxicity occured

Within ( ) is number of cases

Age 51-60 (5)

Age 61-70 (6)

Age 31-40(2) Age 71 – (1)


Q2. Past history of cardiac disease

（）内は症例数

None (11)

abnormal cardiac rhythm(1)

valve disease(2)


Q3. Past history of smoking, diabetes and hyperlipidemia

0

2

4

6

8

10

12

14

ありなし不明


Q4. Past history of radiation on the left hand side

あり

なし

不明

Yes (2)

None (10)

Unknown (2)



Q5. Number of doses of G-CSF

O time (5)

1-5 times (1) 6-10 times (3)

11-15 times (1)

16 times- (2)

Unclear (2)



Q6. Cardiac systolic and diastolic disorder

0

2

4

6

8

10

12

（症例数）

Diastolic disorder

Systolic disorder


Q7. Whether you use H2-blocker or not (at the time of using anthracyclin)

Not used (12)

Unknown (2)

(There were no cases of using H2-blocker) Kyoto Breast Cancer Consensus Conference

2011/11/5

Q8. Whether you use antihypertensive or not

あり

なし

不明

Yes (3)

No (10)

Unknown (1)


Yes to antihypertensive were ARB, ARB, β1 nonselective ISA, ARB, Ca-blocker


Q9. The time span from the start of administrating Trastuzumab till EF lowest value

(number of cases)

(Trastuzumab unused cases: 2 were omitted. Also the case where Cessation of drug HCPT and being continued is one case and it belongs to more than 2 years )

(The time span from the start of administrating Trastuzumab till EF lowest value)

0

1

2

3

4

3か月以内６か月以内１年以内 2年以内 2年以上


Q10. Heart failure grade

Grade１（３）


Grade1

Grade2

Grade3

Grade４

Grade5

不明

Grade1(3)

Grade2(2)

Grade3(7)

Unknown (2)


Q11. The detail of administration regarding anthracyclin, taxane and trastuzumab

0

1

2

3

4

5

6

7

8

9

10

Aのみ A→T TH A→H ATH (include both coadministration and gradual administration)

(Number of cases)

A：Anthracyclin T：Taxane H：Trastuzumab


Q12. Total used amount of epirubicin

p=0.168439

(mg/m2)


(N=47) (N=9)

0.000

100.000

200.000

300.000

400.000

500.000

600.000

700.000

800.000

900.000

1000.000

心毒性(-) 心毒性(+)

320 mg/m2 385.5mg/m2

Q13. The time span from the end day of administrating epirubicin till the start of trastuzumab

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

心毒性(＋）心毒性（－）


Q14. Kind of taxane you have used

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

心毒性（＋）心毒性（－）

Doc

Pac

Doc and Pac


Q15. Whether you used antihypertensive or not and the drug you used as antihypertensive

Antihypertensive Yes No Yes No

Ca antagonist 2

Ca antagonist+ARB 1 1

Ca antagonist+α-blocker 1

ARB+α-blocker 1

ARB 1

ACE inhibitor 1

total 7 ５０１８

Cardiac toxicity (-) cardiac toxicity (+)


Q16. H2-blocker usage rate

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

心毒性（＋）心毒性（－）

使用せず

有

不明

N=9


N=57

Q17. G-CSF usage

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

心毒性（＋）心毒性（－） N=57 N=9


“Prevention and Monitoring of Myocardial Toxicity”

Voting


The 12th Kyoto Breast Cancer Consensus Conference

Echocardiography test


Cases where you avoid administration of anthracyclin


For alleviating cardiotoxicity, do you use Artist or CEI against Anthracyclin+Trastuzumab

administrated cases


the 12th kyoto breast cancer consensus conference ...questionnaire results theme “prevention and...

Documents