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Titre du document / Document title

Effects on blood coagulation of adjuvant CNF (Cyclophosphamide, novantrone, 5-Fluorouracil) chemotherapy in stage II breast cancer patients

Auteur(s) / Author(s)

PECTASIDES D. (1) ; TSAVDARIDIS D. (2) ; AGGOURIDAKI C. (2) ; TSAVDARIDOU V. (2) ; VISVIKIS A. (1) ; TSATALAS K. (3) ; FOUNTZILAS G. (2) ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

(1) Metaxas Memorial Cancer Hospital, Piraeus, Thessaloniki, GRECE
(2) AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, GRECE
(3) Medical School of Thrace, GRECE

Résumé / Abstract

We prospectively studied the alterations of coagulation during adjuvant CNF (Cyclophosphamide, Novantrone -Mitoxantrone, 5-Fluorouracil) chemotherapy in patients with stage II breast cancer. In 50 consecutive stage II breast cancer patients (pre-peri-postmenopausal), and 50 controls,serial coagulation parameters including prothrombin time (P.T.), partial thromboplastin time (P.T.T.), fibrinogen, fibrinogen/ fibrin degradation products (F.D.P.), protein C. protein S, antithrombin III (AT-III) and platelet count were performed. Blood samples for coagulation tests were collected at pretherapy midtherapy (before the 3rd course), before the 6th course of chemotherapy, and 2 months after the cessation of therapy (post-therapy) of 6 cycles of adjuvant chemotherapy (Cyclophosphamide 500 mg/m2, Novantrone 10 mg/m2, 5-Fluorouracil 500 mg/m2). Chemotherapy was repeated every 3 weeks. None of our stage II breast cancer patients receiving adjuvant CNF chemotherapy developed thromboembolic complications. Before any treatment all the tested coagulation parameters were within the normal limits as compared to controls. No statistically significant changes of FDP were noted throughout the study. Fibrinogen, plasma protein C, protein S and AT-III were significantly decreased during chemotherapy. This decline was more evident at midtherapy. Their levels returned to the pretherapy values 2 months after the completion of chemotherapy. The P.T. was statistically shortened, while the P.T.T. showed a statistically significant prolongation during chemotherapy. In conclusion, it appears that monitoring stage II breast cancer with sophisticated coagulation tests during adjuvant CNF chemotherapy can not identify patients at high risk for thromboembolic events. These serially performed coagulation tests, could be considered as a cost-intensive monitoring and not justifiable as a screening for breast cancer patients receiving adjuvant chemotherapy. However, the increasing number of reports of life-threatening and sometimes fatal thromboembolic events following chemotherapy or hormonochemotherapy are of great concern. Our results suggest caution when using chemotherapeutic agents in patients with other thrombosis risk factors, since a significant decrease of protein C and protein S was observed in all patients.Additional studies are required to determine the exact association between chemotherapy and/or hormonochemotherapy and thrombotic events.

Revue / Journal Title

Anticancer research    ISSN  0250-7005 

Source / Source

1999, vol. 19, no4C, pp. 3521-3526 (33 ref.)

Langue / Language

Anglais

Editeur / Publisher

International Institute of Anticancer Research, Attiki, GRECE  (1980) (Revue)

Mots-clés anglais / English Keywords

Malignant tumor

;

Mammary gland

;

Blood coagulation

;

Thromboembolism

;

Risk factor

;

Antineoplastic agent

;

Toxicity

;

Cyclophosphamide

;

Immunosuppressive agent

;

Mitoxantrone

;

Fluorouracil

;

Adjuvant treatment

;

Chemotherapy

;

Antimetabolic

;

Female

;

Human

;

Nitrogen mustard

;

Oxazaphosphinane derivatives

;

Fluoropyrimidine derivatives

;

Pyrimidine derivatives

;

Mammary gland diseases

;

Cardiovascular disease

;

Vascular disease

;

Mots-clés français / French Keywords

Tumeur maligne

;

Glande mammaire

;

Coagulation sanguine

;

Thromboembolie

;

Facteur risque

;

Anticancéreux

;

Toxicité

;

Cyclophosphamide

;

Immunodépresseur

;

Mitoxantrone

;

Fluorouracil

;

Traitement adjuvant

;

Chimiothérapie

;

Antimétabolite

;

Femelle

;

Homme

;

Moutarde à l'azote

;

Oxazaphosphinane dérivé

;

Fluoropyrimidine dérivé

;

Pyrimidine dérivé

;

Glande mammaire pathologie

;

Appareil circulatoire pathologie

;

Vaisseau sanguin pathologie

;

Mots-clés espagnols / Spanish Keywords

Tumor maligno

;

Glándula mamaria

;

Coagulación sanguínea

;

Tromboembolia

;

Factor riesgo

;

Anticanceroso

;

Toxicidad

;

Ciclofosfamida

;

Inmunodepresor

;

Mitoxantrona

;

Fluorouracilo

;

Tratamiento adyuvante

;

Quimioterapia

;

Antimetabólito

;

Hembra

;

Hombre

;

Mostaza al nitrógeno

;

Oxazafosfinano derivado

;

Fluoropirimidina derivado

;

Pirimidina derivado

;

Glándula mamaria patología

;

Aparato circulatorio patología

;

Vaso sanguíneo patología

;

Localisation / Location

INIST-CNRS, Cote INIST : 19426, 35400008093420.0250

Nº notice refdoc (ud4) : 1233551



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