Dynamic monitoring of cardio-specific markers and markers of thyroid gland function in cancer patients--a pilot study

Anticancer Res. 2007 Jul-Aug;27(4A):1883-6.

Abstract

Background: With the increased effectiveness of anticancer therapy, much more attention is being paid to the monitoring of the side-effects of chemotherapy, which often constitute a limiting factor in anticancer therapy. In this pilot study, the results of our monitoring of changes in cardio-specific markers and thyroid gland parameters in patients with colorectal carcinoma in the course of adjuvant and palliative chemotherapy are presented.

Patients and methods: A total of 42 patients with colorectal carcinoma were monitored (median age 52 years, range 34-82 years); in these patients a post-operative adjuvant or palliative chemotherapy was applied (de Gramont's or FOLFIRI regimen). In all of these patients, the cardio-specific markers brain natriuretic peptide (BNP) and troponin I were assessed, as well as markers of thyroid gland function, TSH and FT4.

Results: In the course of chemotherapy, more than half of the patients showed laboratory signs of coronary ischemia; in 6 of these (14%) coronary ischemia was manifested with troponin I levels above 0.3 microg/L. Twenty patients (48%) had laboratory signs of heart failure in the course of adjuvant or palliative chemotherapy. A more frequent incidence of elevated cardio-specific enzymes was observed in continual regimens than in bolus application of fluorouracil. Reduced TSH values were observed in the course of chemotherapy in 9 patients (21%), without changes in FT4 values. An increase in TSH values was observed in 4 patients (10%), again without changes in FT4 values.

Conclusion: The pilot study demonstrated that in patients undergoing treatment for colorectal carcinoma by adjuvant or palliative chemotherapy on the basis of 5-fluorouracil, it is advisable to check for possible cardiotoxicity and simultaneously to monitor thyroid gland functions. This systematic monitoring may improve the quality of life in cancer patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Chemotherapy, Adjuvant / adverse effects
  • Colorectal Neoplasms / drug therapy
  • Fluorouracil / administration & dosage
  • Fluorouracil / adverse effects
  • Heart / drug effects*
  • Heart Failure / chemically induced
  • Humans
  • Middle Aged
  • Myocardial Ischemia / chemically induced
  • Natriuretic Peptide, Brain / drug effects
  • Palliative Care
  • Pilot Projects
  • Thyroid Gland / drug effects*
  • Thyrotropin / drug effects
  • Thyroxine / drug effects
  • Troponin I / drug effects

Substances

  • Troponin I
  • Natriuretic Peptide, Brain
  • Thyrotropin
  • Thyroxine
  • Fluorouracil