Yıl 2021, Cilt 14 , Sayı 2, Sayfalar 362 - 370 2021-04-01

The impact of elevated cumulative anthracycline dose on cardiac repolarization changes in children with cancer: a prospective study
Artan kümülatif antrasiklin dozunun kanserli çocuklarda kardiyak repolarizasyon değişikliklerine etkisi: prospektif bir çalışma

Sultan AYDİN KÖKER [1] , Yesim OYMAK [2] , Timur MEŞE [3] , Murat YILMAZER [4] , Bengü DEMİRAĞ [5] , Rahmi ÖZDEMİR [6] , Tuba Hilkay KARAPINAR [7] , Dilek İNCE [8] , Raziye VERGİN [9]


Aim: We aimed to prospectively interpret the cardiac repolarization changes with 12-lead electrocardiography (ECG) in children with cancer who were treated with anthracycline drugs. Materials and Methods: A total of 53 patients with cancer treated with anthracycline were enrolled in the study. During 6 months follow-up, standard 12-lead ECG was performed at basal, 1st, 4th, and 24th hours after first dose of anthracycline treatment, at the time of 120mg/m2 cumulative anthracycline dose and 240mg/m2 of cumulative anthracycline dose in same patients, respectively. P dispersion(PWd), QT dispersion(QTd), corrected QT dispersion(QTcd), Tp-e interval, Tp-e/QT and Tp-e/QTc ratio were obtained from 12-lead ECG. The patients were classified into three groups according to increasing cumulative anthracycline doses: Group1: first dose(n=53), Group2:120 mg/m2(n=53), Group3:240 mg/m2(n=53). Results: The median age was 48 months(range 9-192 months). While PWd, QTd, QTcd, and Tp-e interval were significantly increased during first 24 hours of the first dose (p<0.001, p=0.005, p=0.041, p=0.016, respectively), Tp-e/QT and Tp-e/QTc ratios were significantly altered during first 24 hours of 120mg/m2 cumulative dose of anthracycline treatment(p<0.001). Any changes in 12-lead ECG were not significantly at 240mg/m2 cumulative dose. However, it was detected that all variables were affected according to each increased anthracycline cumulative dose despite it was not statistically significant. Conclusions: ECG parameters such as PWd, QTd, QTcd, Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios are useful for detecting subclinical cardiac abnormality and acute anthracycline toxicity during both uses of single-dose anthracycline and increased anthracycline doses. These parameters may also predict arrhythmias in patients with cancer.
Amaç: Antrasiklin kemoterapisi ile tedavi edilen kanserli çocuklarda kardiyak repolarizasyon değişikliklerini 12 derivasyonlu elektrokardiyografi (EKG) ile değerlendirmeyi amaçladık. Gereç ve yöntem: Çalışmaya antrasiklin ile tedavi edilen kanserli toplam 53 hasta çalışmaya dahil edildi. Bu hastalara 12 derivasyonlu EKG ile antrasiklin tedavisinin ilk dozu, 120 mg/m2 kümülatif dozu ve 240 mg/m2 kümülatif dozu verilir ikenki her doz uygulaması sırasında ilaç verilmeden hemen önce, ilaç verildikten sonraki 1., 4. Ve 24. Saatteki EKG’leri çekildi. Bu EKG’lerden P dispersiyonu (PWd), QT dispersiyonu (QTd), düzeltilmiş QT dispersiyonu (QTcd), Tp-e aralığı, Tp-e / QT ve Tp-e / QTc oranı hesaplandı. Hastalar artan kümülatif antrasiklin dozlarına göre üç gruba ayrıldı: Grup 1: ilk doz (n = 53), Grup 2: 120 mg / m2 (n = 53), Grup 3: 240 mg / m2 (n = 53). Bulgular: Ortanca yaş 48 ay (aralık 9-192 ay) idi. İlk dozun ilk 24 saatinde PWd, QTd, QTcd ve Tp-e değişkenleri anlamlı olarak artış gösterdiği saptandı. (sırasıyla p <0,001, p = 0,005, p = 0,041, p = 0,016). 120mg / m2 kümülatif antrasiklin tedavisinin ilk 24 saatinde ise Tp-e/QT and Tp-e/QTc oranları istatistiksel anlamlı olarak değişiklik gösterdi (p <0.001). 240 mg / m2 kümülatif antrasiklin dozunda ise herhangi bir anlamlı değişiklik saptanmadı. Ancak istatistiksel olarak anlamlı olmamakla birlikte, artan her antrasiklin kümülatif dozuna göre disperisyon değişkenlerinde uzama, Tp-e / QT ve Tp-e / QTc oranlarında ise azalma olduğu belirlendi. Sonuç: PWd, QTd, QTcd, Tp-e aralığı, Tp-e / QT ve Tp-e / QTc oranları gibi EKG değişkenleri, hem tek doz antrasiklin hem de artan antrasiklin kullanımı sırasında subklinik kardiyak anormalliği ve akut antrasiklin toksisitesini saptamak için yararlı olduğunu saptadık. Bu parametreler değerlendirildiğinde kanserli hastalarda aritmileri de belirlemede önemli olacaktır.
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Birincil Dil en
Konular Onkoloji
Yayınlanma Tarihi Nisan 2021
Bölüm Araştırma Makalesi
Yazarlar

Orcid: 0000-0002-8801-7776
Yazar: Sultan AYDİN KÖKER (Sorumlu Yazar)
Kurum: ANTALYA EĞİTİM VE ARAŞTIRMA HASTANESİ
Ülke: Turkey


Orcid: 0000-0002-6908-8309
Yazar: Yesim OYMAK
Kurum: SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, İZMİR DR. BEHÇET UZ ÇOCUK HASTALIKLARI VE CERRAHİSİ SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ
Ülke: Turkey


Orcid: 0000-0002-4433-3929
Yazar: Timur MEŞE
Kurum: SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, İZMİR DR. BEHÇET UZ ÇOCUK HASTALIKLARI VE CERRAHİSİ SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ
Ülke: Turkey


Orcid: 0000-0003-0819-5829
Yazar: Murat YILMAZER
Kurum: SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, İZMİR DR. BEHÇET UZ ÇOCUK HASTALIKLARI VE CERRAHİSİ SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ
Ülke: Turkey


Orcid: 0000-0003-4399-0844
Yazar: Bengü DEMİRAĞ
Kurum: SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, İZMİR DR. BEHÇET UZ ÇOCUK HASTALIKLARI VE CERRAHİSİ SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ
Ülke: Turkey


Orcid: 0000-0002-2775-166X
Yazar: Rahmi ÖZDEMİR
Kurum: DUMLUPINAR ÜNİVERSİTESİ, KÜTAHYA FOLKLOR ARAŞTIRMA VE UYGULAMA MERKEZİ
Ülke: Turkey


Orcid: 0000-0002-4714-332X
Yazar: Tuba Hilkay KARAPINAR
Kurum: SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, İZMİR DR. BEHÇET UZ ÇOCUK HASTALIKLARI VE CERRAHİSİ SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ
Ülke: Turkey


Orcid: 0000-0002-7914-7886
Yazar: Dilek İNCE
Kurum: DOKUZ EYLÜL ÜNİVERSİTESİ, DOKUZ EYLÜL ÜNİVERSİTESİ HASTANESİ SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ
Ülke: Turkey


Orcid: 0000-0002-8594-9762
Yazar: Raziye VERGİN
Kurum: SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, İZMİR DR. BEHÇET UZ ÇOCUK HASTALIKLARI VE CERRAHİSİ SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ
Ülke: Turkey


Tarihler

Yayımlanma Tarihi : 1 Nisan 2021

Bibtex @araştırma makalesi { patd815376, journal = {Pamukkale Tıp Dergisi}, issn = {}, eissn = {1308-0865}, address = {Pamukkale Üniversitesi Tıp Fakültesi Eğitim Blokları Kınıklı kampüsü 20070 Kınıklı, Denizli}, publisher = {Pamukkale Üniversitesi}, year = {2021}, volume = {14}, pages = {362 - 370}, doi = {10.31362/patd.815376}, title = {The impact of elevated cumulative anthracycline dose on cardiac repolarization changes in children with cancer: a prospective study}, key = {cite}, author = {Aydin Köker, Sultan and Oymak, Yesim and Meşe, Timur and Yılmazer, Murat and Demirağ, Bengü and Özdemir, Rahmi and Karapınar, Tuba Hilkay and İnce, Dilek and Vergin, Raziye} }
APA Aydin Köker, S , Oymak, Y , Meşe, T , Yılmazer, M , Demirağ, B , Özdemir, R , Karapınar, T , İnce, D , Vergin, R . (2021). The impact of elevated cumulative anthracycline dose on cardiac repolarization changes in children with cancer: a prospective study . Pamukkale Tıp Dergisi , 14 (2) , 362-370 . DOI: 10.31362/patd.815376
MLA Aydin Köker, S , Oymak, Y , Meşe, T , Yılmazer, M , Demirağ, B , Özdemir, R , Karapınar, T , İnce, D , Vergin, R . "The impact of elevated cumulative anthracycline dose on cardiac repolarization changes in children with cancer: a prospective study" . Pamukkale Tıp Dergisi 14 (2021 ): 362-370 <https://dergipark.org.tr/tr/pub/patd/issue/60284/815376>
Chicago Aydin Köker, S , Oymak, Y , Meşe, T , Yılmazer, M , Demirağ, B , Özdemir, R , Karapınar, T , İnce, D , Vergin, R . "The impact of elevated cumulative anthracycline dose on cardiac repolarization changes in children with cancer: a prospective study". Pamukkale Tıp Dergisi 14 (2021 ): 362-370
RIS TY - JOUR T1 - The impact of elevated cumulative anthracycline dose on cardiac repolarization changes in children with cancer: a prospective study AU - Sultan Aydin Köker , Yesim Oymak , Timur Meşe , Murat Yılmazer , Bengü Demirağ , Rahmi Özdemir , Tuba Hilkay Karapınar , Dilek İnce , Raziye Vergin Y1 - 2021 PY - 2021 N1 - doi: 10.31362/patd.815376 DO - 10.31362/patd.815376 T2 - Pamukkale Tıp Dergisi JF - Journal JO - JOR SP - 362 EP - 370 VL - 14 IS - 2 SN - -1308-0865 M3 - doi: 10.31362/patd.815376 UR - https://doi.org/10.31362/patd.815376 Y2 - 2021 ER -
EndNote %0 Pamukkale Tıp Dergisi The impact of elevated cumulative anthracycline dose on cardiac repolarization changes in children with cancer: a prospective study %A Sultan Aydin Köker , Yesim Oymak , Timur Meşe , Murat Yılmazer , Bengü Demirağ , Rahmi Özdemir , Tuba Hilkay Karapınar , Dilek İnce , Raziye Vergin %T The impact of elevated cumulative anthracycline dose on cardiac repolarization changes in children with cancer: a prospective study %D 2021 %J Pamukkale Tıp Dergisi %P -1308-0865 %V 14 %N 2 %R doi: 10.31362/patd.815376 %U 10.31362/patd.815376
ISNAD Aydin Köker, Sultan , Oymak, Yesim , Meşe, Timur , Yılmazer, Murat , Demirağ, Bengü , Özdemir, Rahmi , Karapınar, Tuba Hilkay , İnce, Dilek , Vergin, Raziye . "The impact of elevated cumulative anthracycline dose on cardiac repolarization changes in children with cancer: a prospective study". Pamukkale Tıp Dergisi 14 / 2 (Nisan 2021): 362-370 . https://doi.org/10.31362/patd.815376
AMA Aydin Köker S , Oymak Y , Meşe T , Yılmazer M , Demirağ B , Özdemir R , Karapınar T , İnce D , Vergin R . The impact of elevated cumulative anthracycline dose on cardiac repolarization changes in children with cancer: a prospective study. Pam Tıp Derg. 2021; 14(2): 362-370.
Vancouver Aydin Köker S , Oymak Y , Meşe T , Yılmazer M , Demirağ B , Özdemir R , Karapınar T , İnce D , Vergin R . The impact of elevated cumulative anthracycline dose on cardiac repolarization changes in children with cancer: a prospective study. Pamukkale Tıp Dergisi. 2021; 14(2): 362-370.
IEEE S. Aydin Köker , Y. Oymak , T. Meşe , M. Yılmazer , B. Demirağ , R. Özdemir , T. Karapınar , D. İnce ve R. Vergin , "The impact of elevated cumulative anthracycline dose on cardiac repolarization changes in children with cancer: a prospective study", Pamukkale Tıp Dergisi, c. 14, sayı. 2, ss. 362-370, Nis. 2021, doi:10.31362/patd.815376