Dranitsaris et al developed a model for predicting the risk of significant cardiac toxicity in a patient with breast cancer who is treated with the anthracycline doxorubin. This can help to identify a patient who may benefit from more aggressive management. The authors are from multiple hospitals and companies in Canada and the United States.
Patient selection: breast cancer treated with doxorubicin (an anthracycline)
Outcome: cardiotoxicity >= Grade 2
Regimens:
(1) standard doxorubicin as 60 mg per square meter every 3 weeks
(2) pegylated doxorubin as 50 mg per square meter every 4 weeks
Parameters:
(1) age of the patient in years
(2) body weight at start of chemotherapy in kilograms
(3) baseline anthracycline exposure in mg per square meter (cumulative dose before starting current chemotherapy)
(4) ECOG performance status
(5) cycle and regimen
|
Parameter |
Finding |
Points |
|
age of the patient |
< 50 years |
0 |
|
|
>= 50 years |
-10 |
|
body weight |
< 70 kg |
0 |
|
|
>= 70 kg |
7 |
|
baseline athracycline exposure |
< 100 mg per square meter |
0 |
|
|
>= 100 mg per square meter |
7 |
|
ECOG status |
0 |
0 |
|
|
>= 1 |
5 |
|
cycle and regimen |
standard, cycle 1 |
2 |
|
|
standard, cycle 2 |
4 |
|
|
standard, cycle 3 |
6 |
|
|
standard, cycle 4 |
10 |
|
|
standard, cycle 5 |
14 |
|
|
standard, cycle 6 |
19 |
|
|
standard, cycle 7 |
26 |
|
|
standard, cycle 8 or more |
33 |
|
|
PEG, cycle 1 |
0 |
|
|
PEG, cycle 2 |
1 |
|
|
PEG, cycle 3 |
1 |
|
|
PEG, cycle 4 |
3 |
|
|
PEG, cycle 5 |
4 |
|
|
PEG, cycle 6 |
6 |
|
|
PEG, cycle 7 |
8 |
|
|
PEG, cycle 8 or more |
10 |
score =
= SUM(points ofr all 5 parameters) + 10
Interpretation:
• minimum score: 0
• maximum score: 52
• The higher the score the greater the risk for cardiac toxicity.
|
Total Score |
Risk |
|
0 to 30 |
(0.00582 * ((score)^2)) - (0037 * (score)) + 0.0558 |
|
30 to 52 |
(0.0466 * ((score)^2)) - (2.151 * (score)) + 26.33 |
Specialty: Hematology Oncology, Cardiology
