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Comparison of epirubicin and doxorubicin cardiotoxicity in children and adolescents treated within the German Cooperative Soft Tissue Sarcoma Study (CWS)

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Abstract

Purpose: Up to now, cardiotoxicity of epirubicin has been studied almost exclusively in adult cancer patients. The aim of this study was to investigate epirubicin in children and adolescents, in comparison with doxorubicin. Methods: About 172 soft tissue sarcoma patients (mean age at diagnosis: 8.3 years), treated with epirubicin (median cumulative dose: 450 mg/m²) or doxorubicin (median cumulative dose: 240 mg/m²) within the high-risk group of the CWS-96 study, were examined in a prospective multicentre study. Heart function was analysed by echocardiography, measuring left-ventricular fractional shortening (FS). The median follow up was 27.7 months. Results: Incidence of clinically manifest cardiomyopathy was 0% (0/60; 95% CI: 0–6.0%) in patients treated with epirubicin, and 0.9% (1/108; 95% CI: 0–5.1%) in patients treated with doxorubicin. A further three patients showed subclinical cardiomyopathy. There was no difference in FS between the two treatment arms. Conclusions: Cardiotoxicity was low in our study. For the short term, cardiotoxicity seems to be only a minor problem in patients treated with epirubicin as applied in this cohort.

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Acknowledgements

We wish to thank E. Hallmen, A. Kessner, and I. Veit for collection, entry and transfer of data. This work was supported by the Deutsche Krebshilfe and the Madeleine Schickedanz KinderKrebs-Stiftung.

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Authors and Affiliations

  1. Department of Pediatric Oncology, LESS Center, University Hospital for Children and Adolescents, Loschgestrasse 15, 91054, Erlangen, Germany

    W. Stöhr, M. Paulides, A. Kremers, T. Langer & J.D. Beck

  2. Department of Pediatric Oncology, Cooperative Soft Tissue Sarcoma Study (CWS), Olgahospital, Stuttgart, Germany

    I. Brecht & J. Treuner

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  1. W. Stöhr
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  2. M. Paulides
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  3. I. Brecht
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  6. T. Langer
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  7. J.D. Beck
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Correspondence to J.D. Beck.

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For the German Late Effects Working Group in the German Society of Pediatric Oncology and Hematology (GPOH)

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Stöhr, W., Paulides, M., Brecht, I. et al. Comparison of epirubicin and doxorubicin cardiotoxicity in children and adolescents treated within the German Cooperative Soft Tissue Sarcoma Study (CWS). J Cancer Res Clin Oncol 132, 35–40 (2006). https://doi.org/10.1007/s00432-005-0041-0

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  • DOI: https://doi.org/10.1007/s00432-005-0041-0

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