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KMID : 0939920190510010357
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대한암학회지
2019 Volume.51 No. 1 p.357 ~ p.367
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Risk Factor Analysis for Secondary Malignancy in Dexrazoxane-Treated Pediatric Cancer Patients
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Kim Hye-Ry
Kang Hyoung-Jin
Park Kyung-Duk
Koh Kyung-Nam
Im Ho-Joon
Seo Jong-JIn
Lee Jae-Wook
Chung Nack-Gyun
Cho Bin
Kim Hack-Ki
Lee Jae-Min
Hah Jeong-Ok
Lee Jun-Ah
Lee Young-Ho
Park Sang-Kyu
Baek Hee-Jo
Kook Hoon
Kim Ji-Yoon
Kim Heung-Sik
Kim Hwang-Min
Chueh Hee-Won
Park Mee-Rim
Yoon Hoi-Soo
Lee Mee-Jeong
Choi Hyoung-Soo
Ahn Hyo-Seop
Kawano Yoshifumi
Park Ji-Won
Hahn Seo-Kyung
Shin Hee-Young
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Abstract
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Purpose: Dexrazoxane has been used as an effective cardioprotector against anthracycline cardiotoxicity. This study intended to analyze cardioprotective efficacy and secondary malignancy development, and elucidate risk factors for secondary malignancies in dexrazoxane-treated pediatric patients.
Materials and Methods: Data was collected from 15 hospitals in Korea. Patients who received any anthracyclines, and completed treatment without stem cell transplantation were included. For efficacy evaluation, the incidence of cardiac events and cardiac event-free survival rates were compared. Data about risk factors of secondary malignancies were collected.
Results: Data of total 1,453 cases were analyzed; dexrazoxane with every anthracyclines group (D group, 1,035 patients) and no dexrazoxane group (non-D group, 418 patients). Incidence of the reported cardiac events was not statistically different between two groups; however, the cardiac event-free survival rate of patients with more than 400 mg/m2 of anthracyclines was significantly higher in D group (91.2% vs. 80.1%, p=0.04). The 6-year cumulative incidence of secondary malignancy was not different between both groups after considering follow-up duration difference (non-D, 0.52%±0.37%; D, 0.60%±0.28%; p=0.55). The most influential risk factor for secondary malignancy was the duration of anthracycline administration according to multivariate analysis.
Conclusion: Dexrazoxane had an efficacy in lowering cardiac event-free survival rates in patients with higher cumulative anthracyclines. As a result of multivariate analysis for assessing risk factors of secondary malignancy, the occurrence of secondary malignancy was not related to dexrazoxane administration.
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KEYWORD
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Dexrazoxane, Childhood, Cancer, Anthracyclines, Risk factors, Second neoplasm
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